Suicide: Allostatic regulation and resilience

Chinese hospital staff in anxiety and depression: Not only comfort patients but also should be comforted - A nationwide cross-sectional study

BACKGROUND

Healthcare professionals are in short supply worldwide, especially in China, which can result in increased stress in the work environment and allostatic load for Chinese hospital staff. This study aimed to investigate the prevalence of anxiety and depressive symptoms and their relationship with total stress, allostatic overload, sleep quality, and episodic memory among Chinese hospital staff.

METHOD

In this cross-sectional study, self-assessments including Generalized Anxiety Disorder 7-item (GAD-7), Patient Health Questionnaire-9 (PHQ-9), PsychoSocial Index (PSI), Pittsburgh Sleeping Quality Index (PSQI), and MemTrax test were used to evaluate participants' anxiety symptoms, depressive symptoms, total stress, allostatic load/overload, sleep quality, and episodic memory.

RESULTS

A total of 9433 hospital staff from 304 cities participated. Anxiety prevalence was 21.0 % (95 % confidential interval (CI) 20.2 %, 21.8 %), while the prevalence of depressive symptoms was at 21.4 % (95 % CI 20.5 %, 22.2 %). 79.8 % (95 % CI 79.0 %, 80.6 %) of the hospital staff had allostatic overload. Poor sleep quality affected 50.4 % of participants, and 32.1 % experienced poor episodic memory.

LIMITATIONS

This study utilized a convenience sampling approach, relying on an online survey as its data collection method.

CONCLUSIONS

Hospital staff in China are facing a stressful environment with a high prevalence of anxiety and depressive symptoms, significant allostatic overload, poor sleep quality, and compromised episodic memory. It is imperative that local management and community structures enhance their support and care for these essential workers, enabling them to manage and withstand the stresses of their professional roles effectively.

Psychological Resilience and Stress Coping Styles in Migraine Patients

PURPOSE

It was aimed to determine the level of psychological resilience and to investigate the psychological and clinical parameters that affect the resilience level in migraine patients.

PATIENTS AND METHODS

A total of 100 migraine patients and 100 healthy controls who agreed to participate in the study filled in the sociodemographic data form and also Beck Anxiety Scale, Beck Depression Scale, Psychological Resilience Scale for Adults, Perceived Stress Scale, Stress Coping Styles Scale, and Psychological Well-Being Scale. Also, the results of Migraine Disability Assessment Scale (MIDAS) were recorded in order to determine the clinical parameters of migraine patients.

RESULTS

When the migraine patients were examined in terms of the number of painful days in the last 3 months, duration of illness, and correlations between clinical scales, there were statistically significant correlations between the psychological resilience scale and well-being (r=0.691 p<0.001), positive coping styles (r=0.676 p<0.001), Beck depression scale (r=-0.670 p<0.001).

CONCLUSION

Self-confident approach, social support-seeking approach, and level of psychological well-being predict psychological resilience in migraine patients. Interventions aiming to increase the level of psychological resilience, which is negatively correlated with depression, are expected to increase the quality of life of patients with migraine.

Investigating suicide related behaviours across sexual orientation and neighbourhood deprivation levels: A cohort study using linked health administrative data

BACKGROUND

There have been no studies examining how neighbourhood deprivation modifies the effects of sexual minority status on suicide-related behaviours (SRB). Sexual minority individuals in deprived areas may face unique challenges and stressors that exacerbate their risk of SRB. This study aims to investigate the association between sexual minority status and clinical SRB, and examine whether the effect of neighbourhood deprivation differs across sexual orientation.

METHODS

A population-representative survey sample (169,090 respondents weighted to represent 8,778,120 individuals; overall participation rate 75%) was linked to administrative health data in Ontario, Canada to measure SRB-related events (emergency department visits, hospitalizations, and deaths) from 2007 to 2017. Neighbourhood-level deprivation was measured using the Ontario Marginalisation index measure of material deprivation at the dissemination area level. Discrete-time survival analysis models, stratified by sex, tested the effects of neighbourhood deprivation and sexual minority status, while controlling for individual-level covariates.

RESULTS

Sexual minority men had 2.79 times higher odds of SRB compared to their heterosexual counterparts (95% CI 1.66 to 4.71), while sexual minority women had 2.14 times higher odds (95% CI 1.54 to 2.98). Additionally, neighbourhood deprivation was associated with higher odds of SRB: men in the most deprived neighbourhoods (Q5) had 2.01 times higher odds (95% CI 1.38 to 2.92) of SRB compared to those in the least deprived (Q1), while women had 1.75 times higher odds (95% CI 1.28 to 2.40). No significant interactions were observed between sexual minority status and neighbourhood deprivation levels.

CONCLUSION

In both men and women, sexual minority status and neighbourhood deprivation are independent risk factors for SRB. Despite the lack of effect modification, sexual minorities living in the most deprived neighbourhoods have the highest chances of SRB. Future investigations should evaluate interventions and policies to improve sexual minority mental health and address neighbourhood deprivation.