General Health Questionnaire (GHQ-12), Beck Depression Inventory (BDI-6), and Mental Health Index (MHI-5): psychometric and predictive properties in a Finnish population-based sample

Effectiveness of artificial intelligence in detecting and managing depressive disorders: Systematic review

OBJECTIVES

This study underscores the importance of exploring AI's creative applications in treating depressive disorders to revolutionize mental health care. Through innovative integration of AI technologies, the research confirms their positive effects on preventing, diagnosing, and treating depression. The systematic review establishes an evidence base for AI in depression management, offering directions for effective interventions.

METHODS

This systematic literature review investigates the effectiveness of AI in depression management by analyzing studies from January 1, 2017, to May 31, 2022. Utilizing search engines like IEEE Xplore, PubMed, and Web of Science, the review focused on keywords such as Depression/Mental Health, Machine Learning/Artificial Intelligence, and Prediction/Diagnosis. The analysis of 95 documents involved classification based on use, data type, and algorithm type.

RESULTS

The study revealed that AI in depression management excelled in accuracy, particularly in monitoring and prediction. Biomarker-derived data demonstrated the highest accuracy, with the CNN algorithm proving most effective. The findings affirm the therapeutic benefits of AI, including treatment, detection, and disease prediction, highlighting its potential in analyzing monitored data for depression management.

LIMITATIONS

This study exclusively examined the application of AI in individuals with depressive disorders. Interpretation should be cautious due to the limited scope of subjects to this specific population.

CONCLUSIONS

To introduce digital healthcare and therapies for ongoing depression management, it's crucial to present empirical evidence on the medical fee payment system, safety, and efficacy. These findings support enhanced medical accessibility through digital healthcare, offering personalized disease management for patients seeking non-face-to-face treatment.

Estimating risk of loneliness in adulthood using survey-based prediction models: A cohort study

It is widely accepted that loneliness is associated with health problems, but less is known about the predictors of loneliness. In this study, we constructed a model to predict individual risk of loneliness during adulthood. Data were from the prospective population-based FinHealth cohort study with 3444 participants (mean age 55.5 years, 53.4% women) who responded to a 81-item self-administered questionnaire and reported not to be lonely at baseline in 2017. The outcome was self-reported loneliness at follow-up in 2020. Predictive models were constructed using bootstrap enhanced LASSO regression (bolasso). The C-index from the final model including 11 predictors from the best bolasso -models varied between 0.65 (95% CI 0.61 to 0.70) and 0.71 (95% CI 0.67 to 0.75) the pooled C -index being 0.68 (95% CI 0.61 to 0.75). Although survey-based individualised prediction models for loneliness achieved a reasonable C-index, their predictive value was limited. High detection rates were associated with high false positive rates, while lower false positive rates were associated with low detection rates. These findings suggest that incident loneliness during adulthood. may be difficult to predict with standard survey data.

The evaluation of the General Health Questionnaire (GHQ-12) reliability generalization: A meta-analysis

BACKGROUND

The General Health Questionnaire (GHQ-12) is widely used for detecting psychiatric disorders, but its reliability across different populations remains to be determined.

OBJECTIVE

This meta-analysis aims to evaluate the reliability of GHQ-12 across varied cultural and demographic settings.

METHOD

This meta-analysis evaluates the reliability of General Health Questionnaire [GHQ-12]' across diverse populations, employing a systematic search strategy and rigorous inclusion criteria. This meta-analysis evaluates the General Health Questionnaire (GHQ-12) using a pre-registered protocol (CRD42023488436) to ensure unbiased results. Data from 20 studies published between 2016-2023 were analysed using a random-effects model, with quality assessment guided by COSMIN Risk of Bias and QUADAS-2. This study enhances our understanding of GHQ-12's psychometric properties.

RESULTS

For the GHQ-12 subscales, Cronbach's alpha coefficients were 0.72 (90% CI [0.68, 0.75]) for anxiety and depression, 0.82 (90% CI [0.79, 0.86]) for social dysfunction, and 0.72 (90% CI [0.68, 0.76]) for loss of confidence. However, the analysis showed substantial heterogeneity (I2 = 90.04%), with significant variability in reliability estimates across different studies. The overall Cronbach's alpha was 0.84 (95% Cl [0.810, 0.873]) with SE = 0.016 (90% CI [0.68, 0.82], p < .05), indicating moderate to high internal consistency. Quantifying heterogeneity revealed a substantial level (se = 0.0016, I2 = 96.7%), signifying considerable variability in the reliability estimate among the studies. Results further show Cronbach's alpha coefficients range from 0.82 to 0.85 (95% Cl [0.77, 0.86 to 0.81, 0.90]) for the GHQ 12 items.

CONCLUSION

While reaffirming the GHQ-12's utility in mental health assessment, our findings urge a more cautious and context-aware application of the questionnaire. The substantial heterogeneity and variability in reliability scores indicate a need for further research. Future studies should explore the reasons behind this variability, focusing on cultural, socio-economic, and methodological factors that might influence the GHQ-12's reliability. This critical analysis underscores the need for a deeper understanding of the GHQ-12's applicability and the importance of tailoring mental health assessment tools to specific population characteristics.

Rethinking students' mental health assessment through GHQ-12: evidence from the IRT approach

BACKGROUND

The General Health Questionnaire-12 (GHQ-12) is a widely used screening tool for mental health assessment however its traditional scoring methods and cutoffs may not adequately capture the mental health complexities of younger populations.

METHODS

This study explores GHQ-12 responses from a sample of university students. Possible differences in means scores considering gender, age, academic field and degree course were assessed through t-test or one-way ANOVA as appropriate. To deeper understanding different levels of severity and individual item impact on general distress measurement, we applied Item-Response-Theory (IRT) techniques (two-parameters logistic model). We compared students' population with a population of workers who underwent a similar psychological evaluation.

RESULTS

A total of 3834 university students participated in the study. Results showed that a significant proportion (79%) of students reported psychological distress. Females and younger students obtained significantly higher average scores compared to others. IRT analysis found item-specific variations in mental distress levels, with more indicative items for short-term fluctuations and potential severe mental health concerns. Latent class analysis identified three distinct subgroups among students (including 20%, 37%, 43% of the participants respectively) with different levels of psychological distress severity. Comparison with a population of adults showed that students reported significantly higher scores with differences in the scale behavior.

CONCLUSION

Our results highlighted the unique mental health challenges faced by students, suggesting a reevaluation of GHQ-12 applicability and cutoff scores for younger populations, emphasizing the need for accurate instruments in mental health evaluation.

New psychometric evidence from the Revised Mental Health Inventory (R-MHI-5) in Peruvian adolescents from a network psychometrics approach

BACKGROUND

Mental health is an aspect that has been relegated in recent years, prioritizing physical health care. However, there are more and more mental problems and disorders worldwide. In this context, adolescents are considered at risk for developing psychological difficulties due to the important transition stage they are going through. Given this, an adequate measurement of mental health in the adolescent population is necessary. This research aims to evaluate the internal structure and estimate the reliability of the R-MHI-5.

METHOD

The sample covered 662 adolescents (55.2% men and 44.7% women) aged 12 to 17 years (M = 14.5; SD = 1.6).

RESULTS

Exploratory graph analysis revealed a two-dimensional structure encompassing well-being and psychological distress. Furthermore, confirmatory factor analysis results indicated that a model with two related factors demonstrated superior fit indices (CFI = 0.99; TLI = 0.99; SRMR = 0.04; RMSEA = 0.101) in comparison to a one-dimensional model (CFI = 0.85; TLI = 0.71; SRMR = 0.23; RMSEA = 0.451). Additionally, adequate values were found in the reliability of the dimensions.

CONCLUSION

It is concluded that the R-MHI-5 is an instrument with robust psychometric evidence from the perspective of the EGA and CFA, providing adequate evidence of reliability and validity so that it can be used effectively in future research and prevention and intervention processes. Furthermore, our study is the first to provide psychometric evidence of the scale from a media approach in Peruvian adolescents.

Mental health of healthcare workers during the first year of the COVID-19 pandemic in the Netherlands: a longitudinal study

Purpose

In March 2020, the WHO declared COVID-19 a pandemic. Previous virus outbreaks, such as the SARS outbreak in 2003, appeared to have a great impact on the mental health of healthcare workers. The aim of this study is to examine to what extent mental health of healthcare workers differed from non-healthcare workers during the first year of the COVID-19 pandemic.

Methods

We used data from a large-scale longitudinal online survey conducted by the Corona Behavioral Unit in the Netherlands. Eleven measurement rounds were analyzed, from April 2020 to March 2021 (N = 16,615; number of observations = 64,206). Mental health, as measured by the 5-item Mental Health Inventory, was compared between healthcare workers and non-healthcare workers over time, by performing linear GEE-analyses.

Results

Mental health scores were higher among healthcare workers compared to non-healthcare workers during the first year of the pandemic (1.29 on a 0-100 scale, 95%-CI = 0.75-1.84). During peak periods of the pandemic, with over 100 hospital admissions or over 25 ICU admissions per day and subsequently more restrictive measures, mental health scores were observed to be lower in both healthcare workers and non-healthcare workers.

Conclusion

During the first year of the COVID-19 pandemic, we observed no relevant difference in mental health between healthcare workers and non-healthcare workers in the Netherlands. To be better prepared for another pandemic, future research should investigate which factors hinder and which factors support healthcare workers to maintain a good mental health.

Prevalence of depression in infertile men: a systematic review and meta-analysis

BACKGROUND

Generally, infertile men hide their depression, which can threaten their health and lower their quality of life. Given the role of depression and its impact on people's health, this systematic review and meta-analysis aimed to investigate the prevalence of depression in infertile men.

METHODS

This research is a systematic review and meta-analysis based on preferred reporting items for systematic reviews and meta-analyses (PRISMA). Using the keywords of "Depression", "Emotional Depression", "Infertility", "Prevalence", and "Epidemiology", all English language articles were searched in international databases (PubMed, Cochran library, Web of sciences, Scopus, Embase, PsyINFO, and Google scholar) by two reviewers independently and without considering the time limit until September 2022. Title, abstract, full text and quality of each study were evaluated by two reviewers independently using the Newcastle-Ottawa Scale checklist. The results were analyzed using programming language and R software, and I2 test and Egger's Test were used to check heterogeneity and publication bias, respectively.

RESULTS

Twenty-two studies were included in the systematic part of this study; and 8 different measurement tools were used to identify depression. Then, based on the possibility of meta-analysis, 18 studies were included in 4 subgroups. Given the heterogeneity of the articles, random effect model was used. The overall prevalence of depression in infertile men was 18.30%. The lowest and highest overall prevalence of depression in men was reported to be 14.04% and 23.63% in the Zung Self-Rating Depression Scale (ZDS) and the Depression Anxiety Stress Scales (DASS) tools, respectively. The overall prevalence of depression among infertile men was reported to be 18.55% and 16.75% using the Beck Depression Inventory (BDI) and the Hospital Anxiety and Depression Scale (HADS) tools, respectively.

CONCLUSION

Based on the findings of this study, the significant prevalence of depression in infertile men requires a specific attention and planning. The study revealed varying degrees of depression among infertile men, emphasizing the importance of assessing their mental health, specifically in terms of depression, during infertility treatments as a hidden variable. It is strongly recommended to develop training programs for health service providers to effectively utilize diagnostic tools in this particular field.

Adaptation and validation of the Longer-term Unmet Needs after Stroke (LUNS) monitoring tool in Sri Lanka

BACKGROUND

Globally, stroke is a leading cause of mortality and morbidity. Unmet needs are defined as expressed needs that are not fulfilled by services provided and are considered an important indicator of the adequacy and quality of stroke follow-up care. This study aimed to culturally adapt, modify, translate and validate, the Longer-term Unmet Needs after Stroke (LUNS) monitoring tool, to Sri Lanka. Currently, there is no validated tool in Sri Lanka to assess unmet needs among stroke survivors and unmet needs are not systematically assessed.

METHODS

A phased approach followed to culturally adapt, translate, establish its factorial validity and evaluate the convergent and divergent validity, reliability, and overall acceptability. The process of culturally adapting the tool was carried out using two rounds of the modified Delphi technique. The modified tool was translated to Sinhala and pretested among 10 stroke survivors. A descriptive cross-sectional study was conducted among 119 stroke survivors to establish the factorial validity and convergent and discriminant validity using the GHQ-12 and Barthel Index. The Socio-demographic characteristics of the study participants are presented. Communalities were assessed for 21 items and 2 items were dropped. Factor structure was confirmed with varimax and oblique rotations. The correlation coefficient was calculated to assess convergent and divergent validity. Cronbach's alpha value was calculated to assess internal reliability.

RESULTS

Following the modified Delphi technique, 5 items of LUNS tool were removed, and 5 items were modified. Three new items were added based on expert recommendation. One item related to driving also removed as it does not fit with the factor structure emerged. In establishing factorial validity 5 factors emerged from the exploratory factor analysis. In assessing the convergent and discriminant validity, test results revealed that both General Health Questionnaire-12 (GHQ-12) and Barthel Index significantly correlated as expected with unmet needs. The results of Cronbach's alpha showed that all the factors were moderately high confirming the reliability of the tool.

CONCLUSIONS

The Sinhala version of the LUNS monitoring tool is a valid and reliable instrument to assess the unmet needs of stroke survivors. Assessment of unmet needs will add new insight into evaluation of the quantity, quality, and effectiveness of healthcare interventions received by stroke survivors in Sri Lanka.

Construct validity of the General Health Questionnaire (GHQ-12) in patients with COVID-19 and its demographic and medical correlates

Introduction

The present cross sectional study aimed to evaluate the construct and criterion validity, reliability, and gender and age differences of the 12-item General Health Questionnaire (GHQ-12) among hospitalized patients with COVID-19 in 2020. The criterion validity was assessed via its link with perceived stress, sleep quality, daily life activities, and demographic and medical characteristics.

Methods

A total of 328 COVID-19 patients (55.8% men; Mage = 50.49, SD = 14.96) completed the GHQ-12, the Perceived Stress Scale (PSS), the Pittsburgh Sleep Quality Index (PSQI), the Activities of Daily Life (ADL)-Katz Scale, and the Lawton Instrumental Activities of Daily Living Scale (IADL).

Results

Among 13 factorial models, the three-factor model (successful coping, self-esteem, and stress) was shown to have the best fit. GHQ-12 was positively associated with PSQI, PSS, Hyperlipidemia, psychiatry disorders, hospitalization duration, the change in sleep time, and use of sleeping pills, and negatively correlated with educational level, and the number of family members. The GHQ-12 also had a negative correlation with ADL and IADL in over 60 years of age group. Females scored higher on total GHQ-12 scores, compared to males. Finally, the hospitalization duration was longer for patients over 60 (mean = 8.8 days, SD = 5.9) than patients under 60 (mean = 6.35 days, SD = 5.87).

Discussion

Overall, the findings provided evidence that mental distress in patients with COVID-19 is correlated with high perceived stress, low sleep quality, low ADL and IADL, and a range of demographic features and medical conditions. Designing psychological interventions for these patients that target the aforementioned correlates of mental distress is warranted.

A longitudinal study of gambling motives, problem gambling and need frustration

Gambling motives are an important element in understanding the development of problem gambling, yet most of the recent studies investigating their role in problem gambling have been cross-sectional. This study analyzed the links between gambling motives and problem gambling using a longitudinal study design. The moderating effect of the frustration of basic psychological needs was also assessed. The study sample with 1,022 participants (48.43% female, M_age = 49.50 years) was surveyed at three timepoints (T1-T3) in 6-month intervals. The Problem Gambling Severity Index (PGSI) was used to measure problem gambling and need frustration was assessed with The Basic Psychological Need Satisfaction and Frustration Scale (BPNSFS). The data were analyzed using a multilevel mixed-effects regression model where PGSI was the outcome variable. Gambling motives and need frustration were the predictors while psychological distress (measured with the 5-Item Mental Health Inventory, MHI-5), offshore/onshore online gambling, and socio-demographic factors were used as control variables. All the motives predicted problem gambling individually over time. In contrast, motives to escape, to win money, and to compete along with need frustration predicted problem gambling over time in the full model. In addition, money motive and need frustration had an interaction effect so that higher need frustration combined with money motive predicted more severe gambling problems. The results of this study provide a valuable longitudinal perspective on gambling motives, frustration of basic psychological needs, and gambling problems which can be used to develop and improve treatment efforts and programs of problem gambling.

Incidence and persistence of psychological distress during the COVID-19 pandemic among individuals with and without disability

OBJECTIVES

We investigated the incidence (becoming distressed at the follow-up) and persistence (distressed at the baseline and the follow-up) of psychological distress among individuals with and without disability in the period from early 2017 (before the COVID-19 pandemic) to late 2020 (the second wave of the pandemic).

METHODS

We analyzed the population-based FinHealth 2017 survey and its follow-up conducted in 2020 (number of individuals who participated in both surveys: n = 4881; age = 18+). Logistic regressions were applied to investigate differences in the incidence and persistence of psychological distress between people with and without disability. We also investigated whether age, quality of life at the baseline, and perceived increase in loneliness during the COVID-19 pandemic moderated the association between disability and the incidence of distress.

RESULTS

The incidence of psychological distress was higher (OR = 3.01, 95% CI:2.09-4.35) for people with disability (18.9%) than among those without (7.4%), being highest (31.5%) among the youngest participants with disability, aged 18 to 39. People with disability who had a poor quality of life at the baseline were particularly prone to become distressed during the follow-up. People who reported perceived increase in loneliness during the pandemic were prone to become distressed at the follow-up regardless of their disability status. The persistence of distress was more common (OR = 6.00, 95% CI:3.53-10.12) among people with disability (65.7%) than among those without (24.9%).

CONCLUSION

The COVID-19 pandemic had more negative mental health effects on people with disability, especially adults with disability who were young and had a low quality of life before the pandemic.

Parallel latent trajectories of mental health and personal earnings among 16- to 20 year-old US labor force participants: a 20-year longitudinal study

PURPOSE

Determine the number of latent parallel trajectories of mental health and employment earnings over two decades among American youth entering the workforce and estimate the association between baseline sociodemographic and health factors on latent trajectory class membership.

METHODS

This study used data of 8173 participants from the National Longitudinal Survey of Youth 1997 who were 13-17 years old in 1997. Surveys occurred annually until 2011 then biennially until 2017, when participants were 33-37 years old. The Mental Health Inventory-5 measured mental health at eight survey cycles between 2000 and 2017. Employment earnings were measured annually between 1998 and 2017. Latent parallel trajectories were estimated using latent growth modeling. Multinomial logistic regression explored the association between baseline factors and trajectory membership.

RESULTS

Four parallel latent classes were identified; all showed stable mental health and increasing earnings. Three percent of the sample showed a good mental health, steep increasing earnings trajectory (average 2017 earnings ~ $196,000); 23% followed a good mental health, medium increasing earnings trajectory (average 2017 earnings ~ $78,100); 50% followed a good mental health, low increasing earnings trajectory (average 2017 earnings ~ $39,500); and 24% followed a poor mental, lowest increasing earnings trajectory (average 2017 earnings ~ $32,000). Participants who were younger, women, Black or Hispanic, from lower socioeconomic households, and reported poorer health behaviors had higher odds of belonging to the poor mental health, low earnings class.

CONCLUSION

Findings highlight the parallel courses of mental health and labor market earnings, and the influence of gender, race/ethnicity, and adolescent circumstances on these processes.

Basic psychological needs in gambling and gaming problems

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Need frustration was related to the severity of gambling and gaming problems.

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Need satisfaction was not related to the absence of gambling or gaming problems.

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Higher mental health problems were related to the risk of any gaming problems.

Background and Aims

Studies on self-determination theory (SDT) have placed satisfaction of basic psychological needs (autonomy, relatedness, and competence) at the core of well-being, whereas frustration of these needs results in multiple potentially unhealthy mental and behavioral patterns. This study analyzed how need satisfaction and frustration relate to the severity of gambling and gaming problems.

Methods

A survey study with 18–75-year-old Finnish participants (N = 1530; 50.33% male) was conducted in April 2021. Basic psychological needs were measured with the Basic Psychological Need Satisfaction and Frustration Scale, mental health issues with the five-item Mental Health Inventory, gambling problems with the Problem Gambling Severity Index, and gaming problems with the Internet Gaming Disorder Test. Zero-inflated negative binomial analyses were conducted to examine how satisfaction and frustration of basic psychological needs, together with mental health issues, are associated with gaming and gambling problems.

Results

Mental health issues were associated with gambling and gaming problems, but this association became nonsignificant when basic psychological needs were added to the model. However, better mental health still was associated with the absence of gaming problems. While need satisfaction had no association with the absence of gaming or gambling problems, need frustration was associated with increases in the severity of both gaming and gambling problems.

Discussion

Frustration of basic psychological needs for autonomy, relatedness, and competence is associated with both gambling and gaming problems and should be considered when developing treatment and support for those who experience such problems.

Healthcare workers' heterogeneous mental-health responses to prolonging COVID-19 pandemic: a full year of monthly follow up in Finland

BACKGROUND

The COVID-19 pandemic strained healthcare workers but the individual challenges varied in relation to actual work and changes in work. We investigated changes in healthcare workers' mental health under prolonging COVID-19 pandemic conditions, and heterogeneity in the mental-health trajectories.

METHODS

A monthly survey over a full year was conducted for employees of the HUS Helsinki University Hospital (n = 4804) between 4th June 2020 to 28th May 2021. Pandemic-related potentially traumatic events (PTEs), work characteristics (e.g., contact to COVID-19 patients), local COVID-19 incidence, and demographic covariates were used to predict Mental Health Index-5 (MHI-5) and Insomnia Severity Index (ISI) in generalized multilevel and latent-class mixed model regressions.

RESULTS

Local COVID-19 log-incidence (odds ratio, OR = 1.21, with 95% CI = 1.10-1.60), directly caring for COVID-19 patients (OR = 1.33, CI = 1.10-1.60) and PTEs (OR = 4.57, CI = 3.85-5.43) were all independently associated with psychological distress, when (additionally) adjusting for age, sex, profession, and calendar time. Effects of COVID-19 incidence on mental health were dissociable from calendar time (i.e., evolved in time) whereas those on sleep were not. Latent mental-health trajectories were characterized by a large class of "stable mental health" (62% of employees) and minority classes for "early shock, improving" (14%) and "early resilience, deteriorating" mental health (24%). The minority classes, especially "early shock, improving", were more likely to live alone and be exposed to PTEs than the others.

CONCLUSIONS

Healthcare workers faced changing and heterogeneous mental-health challenges as the COVID-19 pandemic prolonged. Adversity and mental ill-being may have accumulated in some employees, and factors like living arrangements may have played a role. Knowledge on employees' demographic and socioeconomic background, as well as further research on the factors affecting employees' resilience, may help in maintaining healthy and efficient workforce in the face of a prolonging pandemic.

Longitudinal association between informal unpaid caregiving and mental health amongst working age adults in high-income OECD countries: A systematic review

BACKGROUND

Informal unpaid caregivers provide most of the world's care needs, experiencing numerous health and wealth penalties as a result. As the COVID-19 pandemic has highlighted, informal care is highly gendered. Longitudinal evidence is needed to assess the causal effect of caregiving on mental health. This review addresses a gap by summarising and appraising the longitudinal evidence examining the association between unpaid caregiving and mental health among working age adults in high-income Organisation for Economic Co-operation and Development (OECD) countries and examining gender differences.

METHODS

Six databases were searched (Medline, PsycInfo, EMBASE, Scopus, Web of Science, Econlit) from Jan 1, 2000 to April 1, 2022. Population-based, peer-reviewed quantitative studies using any observational design were included. Population of interest was working age adults. Exposure was any unpaid caregiving, and studies must have had a non-caregiving comparator for inclusion. Mental health outcomes (depression, anxiety, psychological distress/wellbeing) were measurable by validated self-report tools or professional diagnosis. Screening, data extraction and quality assessment (ROBINS-E) were conducted by two reviewers. The study was prospectively registered with PROSPERO (CRD42022312401).

FINDINGS

Of the 4536 records screened; 13 eligible studies (133,426 participants) were included. Overall quality of evidence was moderate. Significant between-study heterogeneity precluded meta-analysis, so albatross and effect-direction plots complement the narrative synthesis. Results indicate a negative association between informal unpaid care and mental health in adults of working age. Importantly, all included studies were longitudinal in design. Where studies were stratified by gender, caregiving had a consistently negative impact on the mental health of women. Few studies examined men but revealed a negative effect where an association was found.

INTERPRETATION

Our review highlights the need to mitigate the mental health risks of caregiving in working age adults. Whilst men need to be included in further scholarship, reducing the disproportionate caregiving load on women is a crucial requirement for policy development.

FUNDING

Melbourne School of Population and Global Health, Targeted Research Support Grant.

Investigating the impact on mental wellbeing of an increase in pensions: A longitudinal analysis by area-level deprivation in England, 1998-2002

In 1997 approximately two million people aged 60 years or over were living poverty in the UK. In 1999 the UK Government raised real pension incomes of low-income pensioners by around a third through the introduction of the Minimum Income Guarantee (MIG). This study explores the implications of this change for pensioners' mental wellbeing with a focus on differences by area level deprivation in England. We explore mental wellbeing outcomes of 205 men (750 person-year observations) and 367 women (1,336 person-year observations) of state pension age from scores on the General Health Questionnaire from the British Household Panel Survey using a panel difference-in-difference estimation procedure. We compare the mental wellbeing of pensioners receiving MIG to that of low-income pensioners not claiming MIG, from 1998 to 2002. To investigate differences by area deprivation we use quintiles of the of the distributions of the 2000 and 2019 local-authority-level English Index of Multiple Deprivation. Models controlled for age, marital status and year. Between 1998 and 2002, 136 (38%) of low-income women and 57 (28%) of low-income men in the sample were claiming MIG at any one time. Income increased by 31% for men and 22% for women. There was no change in mental wellbeing for women but we found an improvement for men overall and for men living in the most deprived areas, in the latter case with a decrease of the GHQ-12 score of 2.43 points (95% CI: -5.49, 0.02). This estimate was similar across all measures of deprivation, and across both years of IMD. This study provides tentative evidence that the increase in pension income in England for low-income pensioners contributed to a reduction of inequalities in mental wellbeing for men. This needs to be considered in terms of future state pension policies.

Escapism and Excessive Online Behaviors: A Three-Wave Longitudinal Study in Finland during the COVID-19 Pandemic

Excessive online behaviors refer to harmful or disproportionate use of digital network applications. Such behaviors are likely to be associated with escapist motives. Our aim was to analyze whether escapism predicts excessive gambling, excessive gaming, and excessive internet use over time. A longitudinal sample of Finnish residents aged 18-75 years (n = 1022, 51.27% male) was surveyed at three time points during the COVID-19 pandemic in 6-month intervals: April 2021 (Time 1), October-November 2021 (Time 2), and April-May 2022 (Time 3). Of the original Time 1 respondents, 66.80% took part in the surveys at both Time 2 and Time 3. All surveys included measures for excessive gambling (Problem Gambling Severity Index), excessive gaming (Internet Gaming Disorder Test), and excessive internet use (Compulsive Internet Use Scale). Three escapism-specific questions were used to construct a dedicated escapism variable. Socio-demographic variables, alcohol consumption, and psychological distress were used as controls. The study was conducted with multilevel regression analyses using hybrid models. Our research showed that escapism had strong within-person effects on excessive gambling, B = 0.18, p = 0.003; excessive gaming, B = 0.50, p < 0.001; and excessive internet use, B = 0.77, p < 0.001 over time. The between-person effect of escapism was demonstrated on excessive gaming B = 0.91, p < 0.001, and excessive internet use B = 0.61, p = 0.036. Adverse societal events and uncertain times can manifest in excessive online behaviors motivated by escapism, highlighting a need to focus prevention efforts on healthy coping methods.

A Two-Week Vacation in the Tropics and Psychological Well-Being-An Observational Follow-Up Study

Despite the vast annual number of international visitors to the tropics, surprisingly little data are available on the psychological well-being associated with the travels or with travelers’ diarrhoea (TD). We herein recruited participants of a vaccination trial, OEV-123, before their 12-day holiday in Benin, West Africa. We assessed the travelers’ psychological distress with a general health questionnaire (GHQ-12) and retrieved data on TD from the trial database. The GHQ-12 was completed before (wave 0), at return (wave 1), and 1-month after (wave 2) the trip. Of the 174 participants, 73% were women, with a mean age 40 years. Moreover, 24% reported psychological distress before traveling, 10% immediately after, and 16% 1-month after the trip (GHQ-12, 3 or more; 0−12 scoring). The findings showed that psychological well-being increased after the tropical holiday. The GHQ-12 middle wave sum score differed from the wave 0 (p < 0.001) and wave 2 (p = 0.008) sum scores, with travelers reporting highest levels of well-being on their return, with evidence of a lasting improvement. TD was experienced by 71%, and it had a negative impact on psychological well-being only if experienced after travel.

Do the Temperamental Characteristics of Both Mother and Child Influence the Well-Being of Adopted and Non-Adopted Children?

(1) Background: For decades, the temperaments of infants and small children have been a focus of studies in human development and been seen as a potential contributor to children’s developmental patterns. However, less is known about the interplay between the temperamental characteristics of mothers and their children in the context of explaining variations in developmental outcomes. The aim of our study was to explore the associations—with or without genetic links—of the temperaments and psychological distress of mothers and the temperaments of children with behavioral problems in a group of internationally adopted children and their adoptive mothers and in a group of non-adopted children and their mothers. (2) Methods: Data (n = 170) were derived from the ongoing Finnish Adoption (FinAdo) follow-up study. The children included were under the age of 7 years; 74 were adopted internationally through legal agencies between October 2010 and December 2016, and the remaining 96 were non-adopted children living with their birth parents (biological group) recruited from day-care centers. We used Mary Rothbart’s temperament questionnaires to assess temperament, the Child Behavior Checklist (CBCL) to obtain data on the children’s behavioral/emotional problems and competencies, and the General Health Questionnaire (GHQ) to assess parental psychological distress. The study was approved by the Ethics Committee of the Hospital District of Southwest Finland, and written informed consent was obtained from the parents and the children themselves. (3) Results: The negative affectivities of both mothers and children were associated with the total CBCL and with both internalizing and externalizing problem behaviors after adjusting for age, gender, and adoption status. Both relationships remained significant when tested simultaneously, suggesting additive effects. Maternal negative affect was associated with problem behavior irrespective of child extraversion/surgency. Child extraversion/surgency was associated with lower levels of all internalizing behavioral problems when adjusted for maternal sociability. Child negative affect was associated with all behavioral problem measures irrespective of maternal sociability or maternal psychological distress. Maternal distress was associated with child problem behaviors only in children with low extraversion/surgency. (4) Limitations: The sample size was relatively small, and the information was gathered solely with questionnaires. (5) Conclusions: The results of the study may be clinically significant. Child negative affect, maternal negative affect, and maternal experienced distress, combined with low child extraversion/surgency, may increase the risk of child problem behaviors in both adoptees and non-adoptees.

Machine Learning on Early Diagnosis of Depression

To review the recent progress of machine learning for the early diagnosis of depression (major depressive disorder). The source of data was 32 original studies in the Web of Science. The search terms were "depression" (title) and "random forest" (abstract). The eligibility criteria were the dependent variable of depression, the interventions of machine learning (the decision tree, the naïve Bayesian, the random forest, the support vector machine and/or the artificial neural network), the outcomes of accuracy and/or the area under the receiver operating characteristic curve (AUC) for the early diagnosis of depression, the publication year of 2000 or later, the publication language of English and the publication journal of SCIE/SSCI. Different machine learning methods would be appropriate for different types of data for the early diagnosis of depression, e.g., logistic regression, the random forest, the support vector machine and/or the artificial neural network in the case of numeric data, the random forest in the case of genomic data. Their performance measures reported varied within 60.1-100.0 for accuracy and 64.0-96.0 for the AUC. Machine learning provides an effective, non-invasive decision support system for early diagnosis of depression.

Quality of Life and Mental Health Status in Recovered COVID-19 Subjects at Two Years after Infection in Taizhou, China: A Longitudinal Cohort Study

According to previous studies, mental status in 1-year COVID-19 survivors might range from 6–43%. Longer-term psychological consequences in recovered COVID-19 subjects are unknown, so we analyzed longer-term quality of life and mental status in recovered COVID-19 subjects at 2 years after infection. Among 144 recovered COVID-19 subjects in the Taizhou region, 73 and 45 completed face-to-face follow-ups at the first year and second year after infection, respectively, with a 61.7% follow-up rate. The questionnaire, which was administered at both follow-ups, included questions about quality of life, psychological health, and post-traumatic stress disorder (PTSD). The Mann-Whitney U test was used to the differences of each scale between the first and second year. Among the 45 people who completed both follow-up visits, the incidence of psychological problems was 4.4% (2/45) in the first year, and no new psychological abnormalities were observed in the second year. Quality of life improved, while the General Health Questionnaire (GHQ-12) and Impact of Event Scale-Revised (IES-R) scores did not improve over time. The incidence of mental disorders was lower than those in previous studies. Multidisciplinary management for COVID-19 in this study hospital may have reduced the frequency to a certain extent. However, among those with mental health problems, such problems may exist for a long time, and long-term attention should be given to the psychological status of recovered COVID-19 subjects.

Differences in Unfavorable Lifestyle Changes during the COVID-19 Pandemic between People with and without Disabilities in Finland: Psychological Distress as a Mediator

We investigated whether people with disabilities—cognition, vision, hearing, mobility, or at least one of these disabilities—report more COVID-19-related negative lifestyle changes than those without disabilities, and whether psychological distress (MHI-5) mediates the association between disabilities and negative lifestyle changes. Information about COVID-related lifestyle changes among people with disabilities is scarce. We analyzed population-based data from the 2020 FinSote survey carried out between September 2020 and February 2021 in Finland (n = 22,165, aged 20+). Logistic regressions were applied to investigate the effect of the COVID-19 pandemic and related restrictions on negative lifestyle changes—sleeping problems or nightmares, daily exercise, vegetable consumption, and snacking. To test for a mediation effect of psychological distress, the Karlson–Holm–Breen method was used. People with all disability types reported increased sleeping problems or nightmares, and decreased vegetable consumption during the pandemic more frequently than those without. People with mobility and cognitive disabilities more frequently reported decreased daily exercise. People with cognitive disabilities more often reported increased snacking. Psychological distress mediated associations between disabilities and negative lifestyle changes, with the highest association between cognitive disabilities and increased sleeping problems or nightmares (B = 0.60), and the lowest between mobility disabilities and decreased daily exercise (B = 0.08). The results suggest that strategies to promote healthy lifestyles should consider people with disabilities. Alleviating their psychological distress during crisis situations could be one approach.

Stressful Life Events, Differential Vulnerability, and Depressive Symptoms: Critique and New Evidence

Depressive symptoms are disproportionately high among women and less educated individuals. One mechanism proposed to explain this is the differential vulnerability hypothesis-that these groups experience particularly strong increases in symptoms in response to stressful life events. We identify limitations to prior work and present evidence from a new approach to life stress research using the UK Household Longitudinal Study. Preliminarily, we replicate prior findings of differential vulnerability in between-individual models. Harnessing repeated measures, however, we show that apparent findings of differential vulnerability by both sex and education are artifacts of confounding. Men and women experience similar average increases in depressive symptoms after stressful life events. One exception is tentative evidence for a stronger association among women for events occurring to others in the household. We term this the "female vulnerability to network events" hypothesis and discuss with reference to Kessler and McLeod's related "cost of caring" hypothesis.

Spanish Version of the Revised Mental Health Inventory-5 (R-MHI-5): New Psychometric Evidence from the Classical Test Theory (CTT) and the Item Response Theory Perspective (IRT)

The study’s objective was to evaluate the psychometric properties of the revised version of the MHI-5, for which a sample of 1002 university students of both sexes (41.4% men and 58.6% women) between the ages of 17 to 35 years (M = 21.4; SD = 3.4) was collected. Along with the R-MHI-5, other instruments were applied to measure anxiety and depression. Regarding the results, it was evidenced that the model with two related factors presents better fit indices (CFI = .99; TLI = .99; RMSEA = .071) compared to a one-dimensional model (CFI = .74; TLI = .48; RMSEA = .422). Also, it was found that the factorial structure of the MHI-5 did not show evidence of being strictly invariant for the group of men and women. However, it did show evidence of partial invariance for the group of adolescents and adults. Furthermore, the latent relationships model showed that psychological well-being is negatively related to anxiety (− .25) and depression (− .37), and psychological distress is positively related to anxiety (.85) and depression (.87). From the IRT perspective, all items present adequate discrimination indices, with item 4 being the most accurate item to assess psychological well-being. Regarding psychological distress, items 3 and 5 are the most accurate to assess this dimension. It is concluded that the scale that the R-MHI-5 is an instrument with robust psychometric evidence from the perspective of CTT and IRT.

The Fear of Contagion and the Attitude Toward the Restrictive Measures Imposed to Face COVID-19 in Italy: The Psychological Consequences Caused by the Pandemic One Year After It Began

The pandemic nature of COVID-19 has caused major changes in health, economy, and society globally. Albeit to a lesser extent, contingent access to shops and places to socialize the imposition of social distancing and the use of indoor masks is measures still in force today (more than a year after the start of the pandemic), with repercussions on economic, social, and psychological levels. The fear of contagion, in fact, has led us to be increasingly suspicious and to isolate ourselves from the remainder of the community. This has had repercussions on the perception of loneliness, with significant psychological consequences, such as the development of stress, anxiety, and, in extreme cases, depressive symptoms. Starting from these assumptions, this research was developed with the aim of deepening the perceptions that the participants have of their own mental health, loneliness, fear linked to contagion, and attitudes toward imposed social distancing. In particular, we wanted to analyze whether there is a relationship between perceived fear and the perceived level of mental health, loneliness, and attitude toward social distancing. Finally, we wanted to analyze whether there are differences related to gender, age, marital status, current working mode, and educational qualifications. The research, performed after the diffusion of the vaccination in Italy, lasted 14 days. The participants were 500 Italians who voluntarily joined the study and were recruited with random cascade sampling. The research followed a quantitative approach. The analyzed data, from participants residing throughout the national territory, allow us to return the picture of the perceptions that Italians have of the fear of contagion, of their level of mental health, of loneliness and of their attitude toward social distancing. In particular, the data show that fear of COVID-19 is an emotional state experienced by the entire population and that young people have suffered more from loneliness and have been less inclined to accept the imposed social distancing. The data that emerged should make policymakers reflect on the need to find functional strategies to combat COVID-19 or other health emergency crises whose effects do not affect the psychological wellbeing of the population.

Impact of the COVID-19 pandemic on the mental health of professionals in 77 hospitals in France

The COVID-19 pandemic has led to significant re-organisation of healthcare delivery in hospitals, with repercussions on all professionals working in healthcare. We aimed to assess the impact of the pandemic on the mental health of professionals working in health care institutions and to identify individual and environmental factors influencing the risk of mental health disorders. From 4 June to 22 September 2020, a total of 4370 professionals responded to an online questionnaire evaluating psychological distress, severity of post-traumatic stress symptoms, stress factors, and coping strategies. About 57% of the professionals suffered from psychological distress, and 21% showed symptoms of potential post-traumatic stress. Professionals working in radiology, those working in quality/hygiene/security and nurses' aides were the most affected groups. The media focus on the crisis, and a high workload were the most prevalent stress factors, followed by uncertainty regarding the possibility of containing the epidemic, the constantly changing hygiene recommendations/protocols, and the lack of personal protective equipment. The use of coping strategies, notably positive thinking, helped to mitigate the relation between perceived stress and mental health disorders. The COVID-19 pandemic has had far-reaching negative repercussions for all professionals, with some sectors more markedly affected. To prevent mental health disorders in professionals during a public health crisis, support services and management strategies within hospitals should take account of the importance of positive thinking and social support.

Physical condition, psychological status, and posttraumatic stress disorder among recovered COVID-19 subjects: A mediation analysis

The physical condition of individuals who contracted COVID-19 had a profound influence on mitigating the physical and psychological impact of the disease and the symptoms of posttraumatic stress disorder (PTSD). Little attention has been focused on the influence of physical condition on PTSD among recovered COVID-19 subjects. This study explored the relationship between physical and psychological status and PTSD and the potential mechanisms. Questionnaires were completed by 73 (50.7%, 73/144) COVID-19 recovered subjects who were diagnosed in Taizhou, Zhejiang, China. We conducted a face-to-face survey from January 17 to March 10, 2020. The mediation analysis approach was applied in this research. Our data show that recovered COVID-19 subjects who were in better physical condition exhibited fewer psychological problems [B (95%CI), (-1.65 -3.04, -0.26)] and lower PTSD [B (95%CI), -6.13 (-9.43, -2.83)]. In addition, the worse the psychological status of recovered COVID-19 subjects was, the stronger the PTSD (B [95%CI], 0.58 [0.02, 1.14]). Moreover, psychological status could significantly mediate the impact of physical condition on PTSD (_β1θ2 = -0.87). Together, COVID-19 recovered subjects who have better physical condition could decrease their PTSD, and the worse the physical condition of COVID-19 recovered subjects would increase their psychological problems. Our finding about psychological status could significantly mediate the impact of the physical condition on PTSD might be useful for medical institutions and the government seeking to help with the follow-up rehabilitation training of recovered COVID-19 subjects.

Risk and protective factors for the possible development of post-traumatic stress disorder among intensive care professionals in France during the first peak of the COVID-19 epidemic

BACKGROUND

Intensive care units (ICU) are among the healthcare services most affected by the COVID-19 crisis. Stressors related to insecurity, unpredictability, patient death and family distress are significant, and put healthcare workers (HCWs) at high risk of post-traumatic stress disorder (PTSD). The aims of this study were to measure the prevalence of post-traumatic stress disorder in HCWs and to identify risk factors and protective factors during the epidemic in France.

METHODS

During the first peak of the epidemic (from 22 April to 13 May 2020), we assessed sources of stress (PS-ICU scale), mental health (GHQ-12) and coping strategies (Brief-COPE). Three months later (03 June to 6 July 2020), PTSD was assessed using the IES-R scale, with additional questions about sources of support. Data were collected using self-report questionnaires administered online.

RESULTS

Among 2153 professionals who participated in the study, 20.6% suffered from potential PTSD, mostly intrusion symptoms. Risk factors for the development of PTSD were having experienced additional difficult events during the crisis, having a high level of psychological distress, a high level of perceived stress related to the workload and human resources issues, the emotional burden related to the patient and family, and stressors specific to COVID-19 during the first peak of the crisis. The use of positive thinking coping strategies decreased the relationship between perceived stress and the presence of PTSD, while social support seeking strategies increased the relationship. Finally, the HCWs preferred to use support from colleagues, relatives and/or a psychologist, and very few used the telephone hotlines.

CONCLUSION

The epidemic has had a strong traumatic impact on intensive care HCWs. Given the risk of PTSD, we need to consider implementing easily-accessible support services that focus on positive thinking coping strategies, during and after the crisis.

Reaction Time and Visual Memory in Connection to Hazardous Drinking Polygenic Scores in Schizophrenia, Schizoaffective Disorder and Bipolar Disorder

The purpose of this study was to explore the association of cognition with hazardous drinking Polygenic Scores (PGS) in 2649 schizophrenia, 558 schizoaffective disorder, and 1125 bipolar disorder patients in Finland. Hazardous drinking PGS was computed using the LDPred program. Participants performed two computerized tasks from the Cambridge Automated Neuropsychological Test Battery (CANTAB) on a tablet computer: the 5-choice serial reaction time task, or Reaction Time (RT) test, and the Paired Associative Learning (PAL) test. The association between hazardous drinking PGS and cognition was measured using four cognition variables. Log-linear regression was used in Reaction Time (RT) assessment, and logistic regression was used in PAL assessment. All analyses were conducted separately for males and females. After adjustment of age, age of onset, education, household pattern, and depressive symptoms, hazardous drinking PGS was not associated with reaction time or visual memory in male or female patients with schizophrenia, schizoaffective, and bipolar disorder.

Psychological Distress, Dental Health, and Dental Fear among Finnish University Students: A National Survey

The aim of this study was to investigate the association between dental fear, psychological distress, and perceived symptoms of teeth controlled for age, gender, educational sector, and tobacco use. The data from the Finnish University Student Health Survey 2016 targeting students (n = 10,000) of academic universities and universities of applied sciences were used. Psychological distress was measured with the Clinical Outcomes in Routine Evaluation 10 (CORE-10) and the General Health Questionnaire 12 (GHQ-12) and dental fear with the question ‘Do you feel scared about receiving dental care?’. The study included 3110 students. In logistic regression analyses those with psychological distress (measured with CORE-10 and GHQ-12) and those reporting teeth-related symptoms were more likely than their counterparts to have high dental fear. In gender-specific analyses men with psychological distress (measured with CORE-10) and women with teeth-related symptoms were more likely to have high levels of dental fear. Finnish university students with psychological distress and teeth-related symptoms were more likely to experience higher levels of dental fear than their counterparts were. The results of this study support possible common vulnerability factors that dental fear and other psychological disorders may share.

Reaction Time and Visual Memory in Connection to Alcohol Use in Persons with Bipolar Disorder

The purpose of this study was to explore the association of cognition with hazardous drinking and alcohol-related disorder in persons with bipolar disorder (BD). The study population included 1268 persons from Finland with bipolar disorder. Alcohol use was assessed through hazardous drinking and alcohol-related disorder including alcohol use disorder (AUD). Hazardous drinking was screened with the Alcohol Use Disorders Identification Test for Consumption (AUDIT-C) screening tool. Alcohol-related disorder diagnoses were obtained from the national registrar data. Participants performed two computerized tasks from the Cambridge Automated Neuropsychological Test Battery (CANTAB) on A tablet computer: the 5-choice serial reaction time task, or reaction time (RT) test and the Paired Associative Learning (PAL) test. Depressive symptoms were assessed with the Mental Health Inventory with five items (MHI-5). However, no assessment of current manic symptoms was available. Association between RT-test and alcohol use was analyzed with log-linear regression, and eβ with 95% confidence intervals (CI) are reported. PAL first trial memory score was analyzed with linear regression, and β with 95% CI are reported. PAL total errors adjusted was analyzed with logistic regression and odds ratios (OR) with 95% CI are reported. After adjustment of age, education, housing status and depression, hazardous drinking was associated with lower median and less variable RT in females while AUD was associated with a poorer PAL test performance in terms of the total errors adjusted scores in females. Our findings of positive associations between alcohol use and cognition in persons with bipolar disorder are difficult to explain because of the methodological flaw of not being able to separately assess only participants in euthymic phase.

The association of adverse life events and parental mental health with emotional and behavioral outcomes in young adults with autism spectrum disorder

People with autism spectrum disorder (ASD) are at increased risk of developing co-occurring mental health difficulties across the lifespan. Exposure to adverse life events and parental mental health difficulties are known risk factors for developing a range of mental health difficulties. This study investigates the association of adverse life events, parental stress and mental health with emotional and behavioral problems in young adults with ASD. One hundred and fifteen young adults with ASD derived from a population-based longitudinal study were assessed at three time-points (12-, 16-, and 23-year) on questionnaire measures of emotional and behavioral problems. Parent-reported exposure to adverse life events and parental stress/mental health were measured at age 23. We used structural equation modeling to investigate the stability of emotional and behavioral problems over time, and the association between adverse life events and parental stress and mental health and emotional and behavioral outcomes at 23-year. Our results indicate that exposure to adverse life events was significantly associated with increased emotional and behavioral problems in young adults with ASD, while controlling for symptoms in childhood and adolescence. Higher reported parental stress and mental health difficulties were associated with a higher frequency of behavioral, but not emotional problems, and did not mediate the impact of adverse life events. These results suggest that child and adolescent emotional and behavioral problems, exposure to life events and parent stress and mental health are independently associated, to differing degrees, with emotional or behavioral outcomes in early adulthood. LAY SUMMARY: People with autism experience high rates of mental health difficulties throughout childhood and into adult life. Adverse life events and parental stress and mental health may contribute to poor mental health in adulthood. We used data at three time points (12-, 16-, and 23-year) to understand how these factors relate to symptoms at 23-year. We found that emotional and behavioral problems in childhood, adverse life events and parent mental health were all associated with increased emotional and behavioral problems in adulthood.

Mental health and stress among ICU healthcare professionals in France according to intensity of the COVID-19 epidemic

BACKGROUND

We investigated the impact of the COVID-19 crisis on mental health of professionals working in the intensive care unit (ICU) according to the intensity of the epidemic in France.

METHODS

This cross-sectional survey was conducted in 77 French hospitals from April 22 to May 13 2020. All ICU frontline healthcare workers were eligible. The primary endpoint was the mental health, assessed using the 12-item General Health Questionnaire. Sources of stress during the crisis were assessed using the Perceived Stressors in Intensive Care Units (PS-ICU) scale. Epidemic intensity was defined as high or low for each region based on publicly available data from Santé Publique France. Effects were assessed using linear mixed models, moderation and mediation analyses.

RESULTS

In total, 2643 health professionals participated; 64.36% in high-intensity zones. Professionals in areas with greater epidemic intensity were at higher risk of mental health issues (p < 0.001), and higher levels of overall perceived stress (p < 0.001), compared to low-intensity zones. Factors associated with higher overall perceived stress were female sex (B = 0.13; 95% confidence interval [CI] = 0.08-0.17), having a relative at risk of COVID-19 (B = 0.14; 95%-CI = 0.09-0.18) and working in high-intensity zones (B = 0.11; 95%-CI = 0.02-0.20). Perceived stress mediated the impact of the crisis context on mental health (B = 0.23, 95%-CI = 0.05, 0.41) and the impact of stress on mental health was moderated by positive thinking, b = - 0.32, 95% CI = - 0.54, - 0.11.

CONCLUSION

COVID-19 negatively impacted the mental health of ICU professionals. Professionals working in zones where the epidemic was of high intensity were significantly more affected, with higher levels of perceived stress. This study is supported by a grant from the French Ministry of Health (PHRC-COVID 2020).

Pathways to adolescents' health: chronotype, bedtime, sleep quality and mental health

The strong relationship between sleep and health is defined in the literature. While the need for sleep increases in adolescence with the effect of physiological and hormonal changes, the studies have highlighted the serious sleeping problems of adolescents compared to childhood and adulthood. This study aimed to examine the relationship between chronotype, bedtime, sleep quality and mental health among adolescents. This research was a descriptive-relational study. A total of 1083 students constituted the group of the research. The data were collected through the Morningness-Eveningness Questionnaire (MEQ) and General Health Questionnaire and a questionnaire consisting of some questions about sleep. In the evaluation of data, multiple regression, mediation and path analysis were performed. Age, having problems affecting sleep, difficulties falling asleep, sharing the room with someone else and lack of leisure activities were related to bedtime. It was found that determinants of sleep quality were the variables related to sleep itself. Being a male student, having problems affecting sleep, difficulties falling at sleep, waking up during the night, getting support in the morning for waking up and lack of leisure activities negatively affected mental health. MEQ scale was interpreted as a determinant of sleep time, sleep quality, and mental health level. Although the MEQ score directly affected sleep quality, bedtime had a partial mediation role between MEQ score and sleep quality. Sleep quality had a full mediation role between MEQ score and mental health score. School health workers, especially nurses, should consider chronotype-focused measures to improve adolescents' sleep quality and psychosocial health.

Factors contributing to psychological distress in the working population, with a special reference to gender difference

Background

Psychological distress refers to non-specific symptoms of stress, anxiety and depression, and it is more common in women. Our aim was to investigate factors contributing to psychological distress in the working population, with a special reference to gender differences.

Methods

We used questionnaire data from the nationally representative Finnish Regional Health and Well-being Study (ATH) collected in the years 2012–2016 (target population participants aged 20 +, n = 96,668, response rate 53%), restricting the current analysis to those persons who were working full-time and under 65 of age (n = 34,468). Psychological distress was assessed using the Mental Health Inventory-5 (MHI-5) (cut-off value <=52). We studied the following factors potentially associated with psychological distress: sociodemographic factors, living alone, having children under18 years of age, lifestyle-related factors, social support, helping others outside of the home and work-related factors. We used logistic regression analysis to examine association between having work-family conflict with the likelihood for psychological distress. We first performed the models separately for men and women. Then interaction by gender was tested in the combined data for those independent variables where gender differences appeared probable in the analyses conducted separately for men and women.

Results

Women reported more psychological distress than men (11.0% vs. 8.8%, respectively, p < 0.0001). Loneliness, job dissatisfaction and family-work conflict were associated with the largest risk of psychological distress. Having children, active participation, being able to successfully combine work and family roles, and social support were found to be protective factors. A significant interaction with gender was found in only two variables: ignoring family due to being absorbed in one’s work was associated with distress in women (OR 1.30 (95% CI 1.00–1.70), and mental strain of work in men (OR 2.71 (95% CI 1.66–4.41).

Conclusions

Satisfying work, family life and being able to successfully combine the two are important sources of psychological well-being for both genders in the working population.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-021-10560-y.

COVID-19 Pandemic and Helsinki University Hospital Personnel Psychological Well-Being: Six-Month Follow-Up Results

The COVID-19 pandemic has caused an unequally distributed extra workload to hospital personnel and first reports have indicated that especially front-line health care personnel are psychologically challenged. A majority of the Finnish COVID-19 patients are cared for in the Helsinki University Hospital district. The psychological distress of the Helsinki University Hospital personnel has been followed via an electronic survey monthly since June 2020. We report six-month follow-up results of a prospective 18-month cohort study. Individual variation explained much more of the total variance in psychological distress (68.5%, 95% CI 65.2-71.9%) and negative changes in sleep (75.6%, 95% CI 72.2-79.2%) than the study survey wave (1.6%, CI 0.5-5.5%; and 0.3%, CI 0.1-1.2%). Regional COVID-19 incidence rates correlated with the personnel's psychological distress. In adjusted multilevel generalized linear multiple regression models, potentially traumatic COVID-19 pandemic-related events (OR 6.54, 95% CI 5.00-8.56) and front-line COVID-19 work (OR 1.81, 95% CI 1.37-2.39) was associated with personnel psychological distress but age and gender was not. While vaccinations have been initiated, creating hope, continuous follow-up and psychosocial support is still needed for all hospital personnel.

Spiritual Well-Being and Mental Health During the COVID-19 Pandemic in Italy

During the COVID-19 pandemic in Italy, people and families experienced a new and sudden situation that forced them to stay in their homes for a long period (February 25- May 26). In this context, many people found themselves in great difficulty, not only because of the fear of contagion or the economic problems deriving from the closure of production activities but also because the virus profoundly changed the way of life in society. The "Social distancing" concept became central in all personal relationships, including close family relationships. In this situation, our paper seeks to understand the role of spirituality and religiosity in reacting to this difficult situation and in particular on the physical and psychological health of the people involved. The data we present here are part of a multidisciplinary research with a quantitative theoretical framework. As the data was collected during the first Italian lockdown, a total of 1,250 adults from all over Italy participated in the on-line questionnaire. Among the main results it emerged that the participants perceived lower levels of spiritual well-being and mental health than the pre-pandemic situation with a significant gender difference; in fact, women perceived lower mental health than men. At the same time, it is evident that spirituality and religious practices are a protective factor connected not only with psychological and mental but also physical health. Finally, it appears evident that the family is a protective factor with respect to mental health, even in a period so full of stress factors, those who did not live alone and especially those who had to take care of small children reported higher perceived mental health and a greater ability to activate coping resources.

Material hardship and parenting stress among grandparent kinship providers during the COVID-19 pandemic: The mediating role of grandparents' mental health

BACKGROUND

The COVID-19 pandemic has exposed the vulnerability of many families, including grandparent kinship families, to deal with a health/economic crisis. The fear of COVID-19 plus stay-at-home orders have increased individuals' psychological distress. Moreover, school closures and homeschooling further increased parenting stress among caregivers.

OBJECTIVES

This study examined the relationship between material hardship and parenting stress among grandparent kinship providers, and assessed grandparents' mental health as a potential mediator to this relationship during the COVID-19 pandemic in the United States.

PARTICIPANTS AND SETTING

Grandparent kinship providers (N = 362) that took primary care of their grandchildren participated in a cross-sectional survey via Qualtrics Panels in June 2020 in the United States.

METHODS

Descriptive and bivariate analyses, binary logistic regression, and mediation analyses were conducted using STATA 15.0.

RESULTS

Suffering material hardship was significantly associated with higher odds of experiencing parenting stress among grandparent kinship providers, and grandparents' mental health partially mediated this association.

CONCLUSIONS

Addressing material and mental health needs among grandparent kinship providers is critical to decreasing their parenting stress.