Work stress precipitates depression and anxiety in young, working women and men

Assessment of Psychosocial Stress and Mental Health Disorders in Parents and Their Children in Early Childhood: Cross-Sectional Results from the SKKIPPI Cohort Study

BACKGROUND/OBJECTIVES

Early childhood can be a stressful period for families with a significant impact on parents' mental health, the child's healthy development, and the development of a secure mother-child attachment. The goal of the cross-sectional study part of SKKIPPI was to assess the occurrence of psychosocial stress and mental health disorders in parents as well as in their offspring in early childhood in three German regions.

METHODS

Based on random samples from three residents' registration offices, parents with infants aged up to 12 months were invited to participate. An online screening questionnaire was developed in four languages to assess common psychosocial stressors and mental health problems of parents with small children.

RESULTS

The study enrolled 4984 mothers and 962 fathers. The most common potential psychosocial stressors were professional problems (mothers 22%, fathers 33%), lack of social support (20%, 14%), and severe, negative experiences in childhood (22%, 16%). Obsessive-compulsive thoughts (21%, 16%) and depressive (9%, 9%) and anxiety symptoms (11%, 7%) were the most frequently reported mental health problems by both parents. Regulatory problems of the child were reported by between 1.5% and 5.1% of parents.

CONCLUSIONS

The study showed that a substantial proportion of parents are burdened by psychosocial problems and suffer from mental health problems in the first years after the birth of their children. Early preventive and low-threshold support measures should be available in the health and social care system. Low-threshold questionnaires, which cover a wide range of possible stress factors, should be further developed for the practical healthcare of this group of people.

Detection and disclosure of workplace mental health challenges: an exploratory study from India

Workplace mental health challenges have emerged as a significant concern post-pandemic. Despite this, the pervasive stigma surrounding mental illness leads to the concealment of symptoms and reluctance to seek professional help among employees. This study aims to explore the perception of different stakeholders towards the 'Detection and disclosure' of workplace mental health challenges in the Indian context. Fifteen semi-structured interviews were conducted with human resource professionals, counselors, and employees who had previously experienced mental health challenge(s). Thematic analysis was done to identify recurring themes and sub-themes. Three critical pathways were identified: minimizing the inhibitory factors, including lack of awareness, denial, low self-efficacy, stigma, and underestimating organizational capability; maximizing the encouraging factors, including psychological safety, perceived social support, and communicating success stories; and implementing supportive organizational practices, including generating awareness and literacy, build the organizational capability, strengthen the role of managers, leadership advocacy, policies, and processes. By fostering a culture of support and prioritizing employee well-being, organizations in India can create healthier and more resilient work environments, benefiting both individuals and the larger society.

Odor awareness modulates the association between perceived stress and chemosensory anhedonia in women

Chronic stress alters reward sensitivity and contributes to anhedonia. Chemosensation is dominated by a hedonic dimension, but little is known about the association between chronic perceived stress and hedonic chemosensation in non-clinical populations. In the current study, 325 participants (201 females) completed a questionnaire-based survey measuring their chronic perceived stress (Perceived Stress Scale; PSS), chemosensory pleasure (Chemosensory Pleasure Scale; CPS), and olfactory metacognitive abilities (odor awareness, affective impact of odor, importance of olfaction). For females, higher PSS scores significantly predicted lower CPS scores, which is mediated by the positive odor awareness. Moreover, negative odor awareness was identified as a moderator underlying the relationship between PSS and CPS scores in females  but not in males. For females, higher PSS predicted lower CPS for those with lower, but not for those with higher levels of negative odor awareness. These results show that the link between chronic perceived stress and chemosensory anhedonia is pronounced in females, with olfactory perception playing a key role. The current study provides insights into the understanding of stress-related anhedonia and into the development of effective treatments.

The Effects of Positive Psychological Factors on the Mental Wellbeing of Medical Students

Objective A well-established association exists between academic performance and levels of depression and anxiety among medical students. However, the effects of positive psychological factors on symptoms of depression and anxiety and academic performance have not been adequately studied. This study explores the relationship between the above variables and identifies positive psychological factors that can promote medical student wellbeing. Methods Medical students were surveyed at four time points during their first two years of medical education using Qualtrics. The surveys used a five-point Likert scale to assess students' levels of loneliness, religiosity, engaged living, life fulfillment, resilience, psychological wellbeing, and symptoms of depression and anxiety. Academic performance was measured using students' Comprehensive Basic Science Examination scores. Linear mixed effect models with maximum likelihood estimation were used to investigate the relationship between positive psychological factors and scores on depression and anxiety as well as the relationship between demographic and psychological factors and exam scores. Results Seventy-two students completed the study. A significant positive correlation was observed between loneliness and symptoms of depression and anxiety, while the same symptoms had significant negative correlations with engaged living. None of the positive psychological factors were significantly predictive of exam scores. Conclusion Our findings suggest that medical students who develop meaningful relationships and live engaged lives are less likely to develop symptoms of depression and anxiety. Our study lays the groundwork for future research focusing on identifying and implementing pre-clinical curriculum changes aiming to improve medical students' mental health.

Validating Constructs of the Depression, Anxiety, and Stress Scale-21 and Exploring Health Indicators to Predict the Psychological Outcomes of Students Enrolled in the Pacific Islands Cohort of College Students

The Depression, Anxiety, and Stress Scale-21 (DASS-21) has been used in various countries to assess the mental states of individuals. The objectives of this study were to validate the DASS-21 for use in Guam, an island that endures a high burden of mental health challenges, such as suicide, and examine the predictive impact of selected health indicators on DASS-21 variables. Three years of data (2017-2019) were pooled from the Pacific Islands Cohort of College Students (PICCS) study conducted annually at the University of Guam. In total, 726 students were included in the secondary data analysis. MPlus statistical software was used to perform a confirmatory factor analysis (CFA) for the validation and structural equation modeling (SEM) for the predictive modeling. The results from the CFA suggested an acceptable model fit (RMSEA: 0.073, CFI: 0.901, TLI: 0.889, RMR: 0.044), while SEM suggested that sleep quality and physical activity were significant predictors of DASS-21 variables. Therefore, the DASS-21 is a valid instrument for measuring depression, anxiety, and stress among emerging adults in Guam.

Validation of the Pandemic Grief Risk Factors and Its Relationship With Work-Related Stress and Grief Reaction Among Healthcare Workers Who Witnessed Patient Deaths

BACKGROUND

The Pandemic Grief Risk Factors (PGRFs) was developed as a self-report tool to compile a comprehensive list of unique risk factors related to grief when experiencing a coronavirus disease 2019 (COVID-19) loss. We explored the reliability and validity of the PGRF among healthcare workers who witnessed their patients' deaths during the COVID-19 pandemic. Further, we examined whether the general severity of PGRF may have been associated with work-related stress and pandemic grief reactions.

METHODS

An online survey was conducted among tertiary hospital healthcare workers (doctors and nursing professionals) who had witnessed the deaths of patients they cared for. Pandemic Grief Scale for healthcare workers, the Stress and Anxiety to Viral Epidemics-3 items, the Patient Health Questionnaire-9, and the Generalized Anxiety Disorder-7 responses were collected.

RESULTS

In total, 267 responses were analyzed. The single-factor structure of the Korean version of the PGRF showed a good fit for the model. The scale demonstrated good internal consistency and convergent validity with other depression and anxiety rating scales. The mediation analysis revealed that work-related stress directly influenced pandemic grief reactions positively, and depression, anxiety, and general severity of grief risk factors partially mediated the association positively.

CONCLUSION

Among healthcare workers who witnessed the deaths of their patients due to COVID-19, the Korean version of the PGRF was valid and reliable for measuring the overall severity of PGRF. The PGRF can be used to identify individuals at risk for dysfunctional grief.

The relationship between air pollution and depression and anxiety disorders - A systematic evaluation and meta-analysis of a cohort-based study

OBJECTIVE

To explore the correlation between air pollution and the onset of depression and anxiety disorders, to draw more comprehensive and integrated conclusions, and to provide recommendations for maintaining mental health and developing policies to reduce mental health risks caused by air pollution.

METHODS

Meta-analysis of cohort study articles exploring the relationship between air pollution and depression or anxiety disorders included in Pubmed, Web Of Science, CNKI, and Wan Fang database before October 31, 2022, and subgroup analysis of the association between air pollution and depression and anxiety disorders regarding the air pollutants studied, the study population, and Publication bias analysis and sensitivity analysis.

RESULTS

A total of 25 articles meeting the criteria were included in this study, including 23 articles examining the relationship between air pollution and depression and 5 articles examining the relationship between air pollution and anxiety disorders. The results of the meta-analysis were based on the type of pollutant and showed that there was a high degree of heterogeneity among the studies on the relationship between air pollution and depression and a significant heterogeneity among the studies on PM2.5 and the risk of anxiety disorders (I2 = 71%, p < .01), so a random-effects model was selected for the analysis. CO, O3, and SO2 and depression onset had combined RR values of 1.10 (1.00, 1.20), 1.06 (0.87, 1.29), 1.17 (1.06, 1.31), 1.19 (0.90, 1.58), 1.03 (0.99, 1.07), and 1.09 (0.97, 1.24), respectively, and PM2.5 and anxiety The combined RR value for morbidity was 1.10 (0.99, 1.22). The results of sensitivity analysis showed that the combined results were stable and reliable. The results of Egger regression method test showed that none of them had significant publication bias (p > .05).

LIMITATION

Combined exposure to air pollutants on depression and anxiety, further studies by other researchers are needed in the future.

CONCLUSIONS

PM2.5 and NO2 exposure, especially long-term exposure, may be associated with the onset of depression, and no association was found for the time being between PM10, CO, O3, SO2 exposure and depression and PM2.5 exposure and anxiety disorders.

Measuring the Burden of Disease in Korea Using Disability-Adjusted Life Years (2008-2020)

BACKGROUND

The measurement of health levels and monitoring of characteristics and trends among populations and subgroups are essential for informing evidence-based policy decisions. This study aimed to examine the burden of disease in Korea for both the total population and subgroups in 2020, as well as analyze changes in disease burden from 2008 to 2020.

METHODS

We employed the methodology developed in the Korean National Burden of Disease and Injuries Study to calculate disability-adjusted life years (DALYs) by sex, causes, region, and income level from 2008 to 2020. DALYs were derived by combining years of life lost and years lived with disability.

RESULTS

In 2020, the burden of disease for the Korean population was estimated to be 25,439 DALYs per 100,000 population, reflecting a 13.8% increase since 2008. The leading causes of DALYs were diabetes mellitus, followed by low back pain and ischemic stroke. A sex-specific gap reversal was observed, with the disease burden for men surpassing that of women starting in 2017. Furthermore, variations in disease burden were identified across 250 regions and income quintiles.

CONCLUSION

It is imperative to establish appropriate health policies that prioritize the diseases with significantly increasing burdens and subgroups experiencing high disease burdens. The findings of this study are expected to serve as a foundation for developing healthcare policies aimed at improving the health levels of Koreans and achieving health equity.

Developing Peripheral Biochemical Biomarkers of Brain Disorders: Insights from Zebrafish Models

High prevalence of human brain disorders necessitates development of the reliable peripheral biomarkers as diagnostic and disease-monitoring tools. In addition to clinical studies, animal models markedly advance studying of non-brain abnormalities associated with brain pathogenesis. The zebrafish (Danio rerio) is becoming increasingly popular as an animal model organism in translational neuroscience. These fish share some practical advantages over mammalian models together with high genetic homology and evolutionarily conserved biochemical and neurobehavioral phenotypes, thus enabling large-scale modeling of human brain diseases. Here, we review mounting evidence on peripheral biomarkers of brain disorders in zebrafish models, focusing on altered biochemistry (lipids, carbohydrates, proteins, and other non-signal molecules, as well as metabolic reactions and activity of enzymes). Collectively, these data strongly support the utility of zebrafish (from a systems biology standpoint) to study peripheral manifestations of brain disorders, as well as highlight potential applications of biochemical biomarkers in zebrafish models to biomarker-based drug discovery and development.

Association between depressive symptoms and employment type of Korean workers: the Fifth Korean Working Conditions Survey

BACKGROUND

This study analyzed the association between depressive symptoms and employment type, by considering both socioeconomic status and job stress factors.

METHODS

We analyzed 27,369 participants (13,134 men and 14,235 women) using data from the fifth Korean Working Conditions Survey. The participants were divided into regular and precarious workers. Depressive symptoms were defined using the World Health Organization-5 Well-Being Index. A multivariate logistic regression analysis was performed to assess the association between depressive symptoms and employment type.

RESULTS

Of the participants, 71.53% (N = 19578) were regular workers and 28.47% (N = 7791) were precarious workers. The weighted frequencies of participants with depressive symptoms (42.50%) were significantly higher than those of precarious workers (32.54%, p < 0.001). In the univariate and multivariate analyses, precarious workers had a significantly higher risk of depressive symptoms than regular workers (odds ratio [OR] 1.53, 95% confidence interval [CI] 1.42-1.64; OR 1.16, 95% CI 1.07-1.26, respectively). The significant association between depressive symptoms and precarious workers has also been reflected in propensity score matched participants through crude and multivariate analysis (OR 1.54 [95% CI 1.43-1.66] and OR 1.15 [95% CI 1.04-1.26], respectively).

CONCLUSIONS

The findings suggest that precarious workers may have a higher risk of depressive symptoms than regular workers. However, this is only a cross-sectional study. Therefore, further study is required to investigate the relevance association between depressive symptoms and employment types.

Does adolescent depression modify the association between psychosocial job stressors and mental health in emergent adulthood?

BACKGROUND

Job stressors can be particularly harmful to the mental health of disadvantaged groups through differential exposure, differential sensitivity to the effects of exposure, or both. In this paper, we assess the extent to which emergent adult workers with an adolescent history of high depression symptoms may be differentially sensitive to the effect of job stressors on mental health.

METHODS

We conducted a secondary analysis of three waves of the Australian arm of the International Youth Development Study (n = 1262). We used multivariable linear regression to assess whether self-reported measures of high depression symptoms at one or two time points in adolescence (ages 11-16 years) modified the cross-sectional association between four self-reported job stressors (job demands, job control, job strain, and incivility at work) and psychological distress (Kessler-10 scores) in emergent adulthood (ages 23-27 years).

RESULTS

For all four job stressors, there was a consistent pattern of approximately a doubling in the magnitude of association for participants with a history of high depression symptoms at two points in adolescence compared with those with no history of depression. However, results of effect modification analysisfor only job demands and job strain excluded chance as a potential explanation.

CONCLUSIONS

Findings showed partial support for the hypothesis that a history of high depression symptoms in adolescence predicts stronger associations between job stressor exposures and psychological distress among those employed in emergent adulthood. The limitations of this secondary analysis suggest a need for purpose-designed studies to answer this important research question more definitively.

Quantifying the benefits of healthy lifestyle behaviors and emotional expressivity in lowering the risk of COVID-19 infection: a national survey of Chinese population

BACKGROUND

COVID-19 is still prevalent in most countries around the world at the low level. Residents' lifestyle behaviors and emotions are critical to prevent COVID-19 and keep healthy, but there is lacking of confirmative evidence on how residents' lifestyle behaviors and emotional expressivity affected COVID-19 infection.

METHODS

Baseline study was conducted in August 2022 and follow-up study was conducted in February 2023. Baseline survey collected information on residents' basic information, as well as their lifestyle behaviors and emotions. Follow-up study was carried out to gather data on COVID-19 infection condition. Binary logistic regression was utilized to identify factors that may influence COVID-19 infection. Attributable risk (AR) was computed to determine the proportion of unhealthy lifestyle behaviors and emotional factors that could be attributed to COVID-19 infection. Sensitivity analysis was performed to test the robustness of the results.

RESULTS

A total of 5776 participants (46.57% males) were included in this study, yielding an overall COVID-19 infection rate of 54.8% (95%CI: 53.5 - 56.0%). The findings revealed that higher stress levels [aOR = 1.027 (95%CI; 1.005-1.050)] and lower frequency in wearing masks, washing hands, and keeping distance [aOR = 1.615 (95%CI; 1.087-2.401)], were positively associated with an increased likelihood of COVID-19 infection (all P < 0.05). If these associations were causal, 8.1% of COVID-19 infection would have been prevented if all participants had normal stress levels [Attributable Risk Percentage: 8.1% (95%CI: 5.9-10.3%)]. A significant interaction effect between stress and the frequency in wearing masks, washing hands, and keeping distance on COVID-19 infection was observed (β = 0.006, P < 0.001), which also was independent factor of COVID-19 infection.

CONCLUSIONS

The overall COVID-19 infection rate among residents is at a medium level. Residents' increasing stress and decreasing frequency in wearing masks and washing hands and keeping distance contribute to increasing risk of infection, residents should increase the frequency of mask-wearing, practice hand hygiene, keep safe distance from others, ensure stable emotional state, minimize psychological stress, providing evidence support for future responses to emerging infectious diseases.

The Implications of Stress Among Correctional Officers: A Summary of the Risks and Promising Intervention Strategies

This paper provides a detailed summary and discussion of the concept of stress and how it relates to the health, wellbeing, and performance of corrections officers. In line with these objectives, we focus on three areas: (1) providing a more detailed definition of the concept of stress; (2) a discussion of the ways that increased exposure to stress may impact corrections officers' physical and mental health; and (3) a summary of prevention and intervention strategies that are relevant for corrections officers and have shown promise in dampening the consequences of increased stress exposure. More in-depth knowledge of the concept of stress and the underlying processes that link stress to negative outcomes will provide policy makers and corrections departments with an understanding of the characteristics of prevention and intervention strategies that are expected to be most effective in limiting the consequences of stress.

Mindfulness Practice Reduces Hair Cortisol, Anxiety and Perceived Stress in University Workers: Randomized Clinical Trial

BACKGROUND

Anxiety and stress are common mental health conditions reported by university workers. Practices of mindfulness represent one promising approach as an effective and feasible means to reduce stress, improve mental health and promote well-being; however, there are no clinical trials that have combined long-term stress biomarkers (hair cortisol) and psychometric assessments in a sample of university workers.

OBJECTIVE

This study investigated the effectiveness of a mindfulness-based program on long-term stress, by measuring hair cortisol concentration and perceived stress and anxiety among workers who were undergoing high levels of stress.

METHOD

We conducted a randomized clinical trial at work among the employees of a public university. We compared a group that received the eight-week mindfulness intervention with the wait list group who received no intervention.

RESULTS

A total of 30 participants were included in the study, with n = 15 subjects in the intervention group and n = 15 in the control group. Hair cortisol, perceived stress and anxiety significantly reduced after the intervention compared to the control group, which had no appreciable decline in the measured variables.

CONCLUSION

This clinical trial showed the effectiveness of a mindfulness program on mental health psychometric measures (perceived stress and anxiety) and on a long-term stress biomarker (hair cortisol). It can be concluded that an eight-week mindfulness program could be implemented as an effective strategy to reduce stress biomarkers (hair cortisol) as well as perceived stress and anxiety, improving the mental health of university workers.

Health Management: Evaluating the Relationship between Organizational Factors, Psychosocial Risks at Work, Performance Management, and Hospital Outcomes

Introduction-Health system (HS) health organizations are complex and are in constant dynamic interaction with multiple elements, including political, environmental, societal, legal, and organizational factors, along with human components, such as human resources, patients, and other stakeholders. Objective-This research aimed to study three HS organizations, identifying and characterizing the elements of health organizations and the factors related to professionals, determining their influence on economic and financial performance results, as well as results related to the professionals and to the patients comprising the institutions. Method-A quantitative study was conducted in which data were collected through questionnaires from various sources to better understand and characterize the factors related to organizations, professionals, and patients (470 health professionals and 768 patients). To test the integrated evaluation model for health organizations, path analysis was used. Results-The results reveal that the organizational culture (OC) presents a positive relationship between the professional's quality of life (QL) and the performance management (PM) of the professionals, along with a negative relationship with the psychosocial work risks (PWR). There is also a relationship between the OC and patient satisfaction (PS), professional job satisfaction (PJS), and economic and financial results (EFR). In the relationship between the processes and the results, there are significant relationships between PM and PJS and PWR and PJS. In terms of the results, there is a significant relationship between the EFR and the PS. Conclusions-This study contributes to a deeper knowledge of the factors that influence the quality of health organizations and their results and produces recommendations for health organizations to address the current challenges.

The Effectiveness of a Neurofeedback-Assisted Mindfulness Training Program Using a Mobile App on Stress Reduction in Employees: Randomized Controlled Trial

BACKGROUND

Mindfulness-based training programs have consistently shown efficacy in stress reduction. However, questions regarding the optimal duration and most effective delivery methods remain.

OBJECTIVE

This research explores a 4-week neurofeedback-assisted mindfulness training for employees via a mobile app. The study's core query is whether incorporating neurofeedback can amplify the benefits on stress reduction and related metrics compared with conventional mindfulness training.

METHODS

A total of 92 full-time employees were randomized into 3 groups: group 1 received mobile mindfulness training with neurofeedback assistance (n=29, mean age 39.72 years); group 2 received mobile mindfulness training without neurofeedback (n=32, mean age 37.66 years); and group 3 were given self-learning paper materials on stress management during their first visit (n=31, mean age 38.65 years). The primary outcomes were perceived stress and resilience scales. The secondary outcomes were mindfulness awareness, emotional labor, occupational stress, insomnia, and depression. Heart rate variability and electroencephalography were measured for physiological outcomes. These measurements were collected at 3 different times, namely, at baseline, immediately after training, and at a 4-week follow-up. The generalized estimating equation model was used for data analysis.

RESULTS

The 4-week program showed significant stress reduction (Wald χ22=107.167, P<.001) and improvements in psychological indices including resilience, emotional labor, insomnia, and depression. A significant interaction was observed in resilience (time × group, Wald χ42=10.846, P=.02). The post hoc analysis showed a statistically significant difference between groups 1 (least squares mean [LSM] 21.62, SE 0.55) and 3 (LSM 19.90, SE 0.61) at the posttraining assessment (P=.008). Group 1 showed a significant improvement (P<.001) at the posttraining assessment, with continued improvements through the 1-month follow-up assessment period (LSM 21.55, SE 0.61). Physiological indices were analyzed only for data of 67 participants (22 in group 1, 22 in group 2, and 23 in group 3) due to the data quality. The relaxation index (ratio of alpha to high beta power) from the right electroencephalography channel showed a significant interaction (time × group, Wald χ22=6.947, P=.03), with group 1 revealing the highest improvement (LSM 0.43, SE 0.15) compared with groups 2 (LSM -0.11, SE 0.10) and 3 (LSM 0.12, SE 0.10) at the 1-month follow-up assessment.

CONCLUSIONS

The study demonstrated that the neurofeedback-assisted group achieved superior outcomes in resilience and relaxation during the 4-week mobile mindfulness program. Further research with larger samples and long-term follow-up is warranted.

TRIAL REGISTRATION

ClinicalTrials.gov NCT03787407; https://clinicaltrials.gov/ct2/show/NCT03787407.

Daily Effects of COVID-19 News on Personal Protective Behaviors Through COVID-19 Anxiety: The Significance of Direct Wuhan Epidemic Experience

BACKGROUND

Drawing on cognitive appraisal theory, this study investigates the effect of daily COVID-19 news on daily anxiety and protective behaviors (e.g., wearing masks and washing hands). This study proposes that such processes, leading to self-protection, are highly likely when individuals have directly experienced the Wuhan epidemic at the beginning of 2020, which is the most serious COVID-19 outbreak in history.

METHODS

The positive effect of daily COVID-19 news on daily protective behaviors through daily COVID-19 anxiety was examined in this study, which was hypothesized to be accentuated by direct Wuhan epidemic experience. An online survey based on the experience sample method (ESM) was conducted during the COVID-19 epidemic in Hebei Province, China, at the beginning of 2021, in which 82 working adults participated in a daily survey for five consecutive days. Once a day during the five-day period, the participants reported their daily COVID-19 news exposure, daily COVID-19 anxiety, and daily protective behaviors. Wuhan epidemic experience was measured by the place of residence of the participants during the 2020 Wuhan epidemic through a separate general survey conducted before the ESM survey.

RESULTS

Analysis of 392 day-level data confirmed the positive link between daily COVID-19 news and daily protective behaviors, mediated by daily COVID-19 anxiety (b = 0.03, SE = 0.01, p = 0.018). Furthermore, the mediated effect was significant for the participants with direct COVID-19 experience in Wuhan in 2020 (b = 0.05, SE = 0.03, p = 0.041) but not significant for those without direct experience in Wuhan (b = 0.01, SE = 0.01, p = 0.461). Thus, the results confirmed the positive moderating role of Wuhan epidemic experience.

CONCLUSIONS

The analysis reveals the psychological mechanism through which COVID-19 information promotes self-protection measures to control the infectious disease and highlights the importance of direct COVID-19 experience in generating such an effect.

Validation of the Occupational Depression Inventory in Sweden

BACKGROUND

The Occupational Depression Inventory (ODI) was recently devised to assess depressive symptoms that individuals specifically attribute to their work. One purpose of the ODI is to overcome limitations in current assessments of job-related distress. This study aimed to validate the Swedish version of the ODI.

METHODS

The study involved 365 individuals employed in Sweden. In addition to the ODI, the study included the Satisfaction with Life Scale, the Effort-Reward Imbalance Questionnaire, the Demand-Control-Support Questionnaire, the GAD-2, and the PHQ-9. We inquired into the factorial validity, dimensionality, scalability, test-score reliability, criterion validity, convergent validity, discriminant validity, and measurement invariance of the ODI.

RESULTS

Exploratory structural equation modeling bifactor analysis indicated that the ODI's Swedish version meets the requirements for essential unidimensionality (e.g., explained common variance = 0.872). Measurement invariance held across sexes, age groups, and occupational categories. The instrument exhibited strong scalability (e.g., H = 0.662). The observed total scores thus accurately ranked respondents on the latent continuum underlying the scale. The ODI's total-score reliability was high (e.g., McDonald's ω = 0.929). Speaking to the instrument's criterion validity, we found occupational depression to correlate, in the expected direction, with various work (e.g., job support) and nonwork (e.g., general anxiety) variables. Occupational depression showed large correlations with effort-reward imbalance (r = 0.613) and demand-control imbalance (r = 0.566) at work. Multiple regression analyses supported these associations further. As expected, we observed both a degree of convergent validity and a degree of discriminant validity when examining the ODI against the PHQ-9, an attribution-free measure of depression.

DISCUSSION

This study indicates that the ODI performs well within the Swedish context, consistent with the findings obtained in other linguistic and geographic contexts. The ODI promises to help researchers, practitioners, and public health decision-makers address job-related distress more effectively.

Work-related stress, reason for consultation and diagnosis-specific sick leave: How do they add up?

Work-related stress is common in Western society and disorders associated with stress are often managed in primary health care. This study was set to increase the understanding of the relationship between reason for consultation, work-related stress and diagnosis-specific sick leave for primary health care patients. The longitudinal observational study included 232 employed non-sick listed patients at seven primary health care centres in Sweden. Of these patients, 102 reported high work-related stress, as measured with the Work Stress Questionnaire, and 84 were on registered sick leave within one year after inclusion. The study showed that, compared to those who did not report high work-related stress, highly stressed patients more often sought care for mental symptoms (60/102 versus 24/130), sleep disturbance (37/102 versus 22/130) and fatigue (41/102 versus 34/130). The risk for sick leave with a mental diagnosis within a year after base-line was higher among patients reporting high work-related stress than among those who did not (RR 2.97, 95% CI 1.59;5.55). No such association was however found for the risk of sick leave with a musculoskeletal diagnosis (RR 0.55, 95% CI 0.22;1.37). Seeking care for mental symptoms, sleep disturbance and fatigue were associated with having a future mental sick leave diagnosis (p-values < 0.001), while seeking care for musculoskeletal symptoms was associated with having a future musculoskeletal sick leave diagnosis (p-value 0.009). In summary, compared to those who did not report high work-related stress, patients with high work-related stress more often sought care for mental symptoms, sleep disturbance and fatigue which lead to a mental sick leave diagnosis. Reporting high work-related stress was, however, not linked to having sought care for musculoskeletal symptoms nor future sick leave due to a musculoskeletal diagnosis. Hence, both patients and general practitioners seem to characterize work-related stress as a mental complaint.

Relationships of work stress and interpersonal needs with industrial workers' mental health: a moderated mediation model

OBJECTIVES

This study explores whether feelings of defeat (i.e., a sense of failed struggle and losing rank; referred to as defeat for simplicity) mediated the effect of work stress on depression/anxiety, the effect of interpersonal needs on depression/anxiety for Chinese industrial workers, and the possible moderating role of social support.

METHOD

A cross-sectional study was conducted in Shenzhen, China in 2019, in total, 2023 industrial workers (of 2700 invited; response rate = 75%) completed a self-administered survey consisted of Job Stress Scale, Interpersonal Needs Questionnaire, Defeat Scale, Centre for Epidemiological Studies Depression Scale, Generalized Anxiety Disorder Scale, two face-valid questions for social support, as well as sociodemographic information. Moderated mediation model was tested and loop plots were applied to probe into the conditional effects of work and interpersonal stress on depression and anxiety symptoms.

RESULT

Both the direct and indirect effect of work stress on depression and anxiety through defeat were significant (Work stress→ Depression: B = 0.035, p < .001, Work stress→ Defeat→ Depression: B = 0.034, p < .001; Work stress→ Anxiety: B = 0.038, p < .001, Work stress→ Defeat→ Anxiety: B = 0.045, p < .001). Meanwhile, defeat mediated the relationship of interpersonal needs with depression partially and the relationship of interpersonal needs with anxiety totally (Interpersonal needs→ Anxiety: B = 0.133, p < .001, Interpersonal needs→ Defeat→ Anxiety: B = 0.010, p = .537). Social support moderated the indirect path between interpersonal needs and depression/anxiety and buffered the effect.

CONCLUSION

The mediating role of defeat and the moderator role of social support in the relationship between stress and depression/anxiety were confirmed in industrial workers. Workers who reported more work and interpersonal stress would report more defeat feelings, and then exhibited more depression and anxiety symptoms; this mediation effect was stronger for those who had lower social support, respectively.

Links between pet ownership and exercise on the mental health of veterinary professionals

Background

Connections between the effects of pet ownership and exercise on mental health have previously been demonstrated in different populations. However, little is known about the potential effects of pet ownership and exercise on the mental health of veterinary professionals. Since these individuals have a high prevalence of poor mental health and suicide, while they deal with pets professionally, we investigated the impact of pet ownership, exercise and different types of pet ownership on this demographic group.

Method

Veterinary professionals over 18 years old answered an online questionnaire about pet ownership, exercise, mental health (including anxiety, depression and suicidal ideation) and mental health correlates. Regression models were used to identify variables significantly related to mental health outcomes.

Results

Of 1087 respondents, pet owners were more depressed than non-owners, while anxiety or suicidal ideation was not associated with pet ownership. Dog and horse owners were psychologically healthier (less anxiety, less suicidal ideation) than non-owners of these species. Veterinary professionals who ran regularly had lower anxiety and depression. Those who walked regularly and spent less time sitting experienced fewer depression symptoms.

Conclusions

Running, walking and avoiding prolonged sitting might protect the mental health of veterinary professionals. The type of pet owned may be an important factor in the relationship between pet ownership and mental health; however, generally, pet ownership was associated with worse mental health outcomes in this demographic group. Future studies should determine the causal nature of these relationships.

Teacher stress among public primary and secondary schoolteachers in Datong, a city of Shanxi Province, China: association between teacher stress and standardized workload

OBJECTIVES

The policy of the standardized workload has been implemented among primary and secondary schoolteachers in Shanxi Province. The aim of this cross-sectional cohort study is to assess teacher stress among primary and secondary schoolteachers in Datong, a city of Shanxi Province and the association between teacher stress and the quantified workload.

MATERIAL AND METHODS

Three hundred and fifty schoolteachers in 10 public primary schools, 187 schoolteachers in 6 secondary schools and 268 non-teachers in 21 education institutes were recruited. A single-item rating assessment of work-related stress was completed by using the Exposure to Job Stress measure with modification. The quantified workload included class size, teaching hours, and subjects. Descriptive and logistic regression analyses were carried out.

RESULTS

In 805 participants, the pro- portion of primary and secondary schoolteachers with moderate stress was significantly greater. The results of Spearman's correlation and logistic regression analyses showed that the occupations of the primary and secondary schoolteachers had higher stress risk. Further, the stratified results showed that among the primary schoolteachers, the independent stress risk factor was larger class size; while among the secondary schoolteachers, the stress associated factor was more weekly teaching hours.

CONCLUSIONS

After standardization of the workload, there remain higher levels of work stress among primary and secondary schoolteachers. Notwithstanding, the stress state in teachers is manageable and they may be faced with controllable stressors. Int J Occup Med Environ Health. 2023;36(2):161-76.

A Novel Screening, Brief Intervention, and Referral to Treatment (SBIRT) Based Model for Mental Health in Occupational Health Implemented on Smartphone and Web-Based Platforms: Development Study With Results From an Epidemiologic Survey

BACKGROUND

While the importance of mental health is well-recognized in the field of occupational health, implementation of effective strategies in the workplace has been limited by gaps in infrastructure, program comprehensiveness, coverage, and adherence. The authors developed a Screening, Brief Intervention, and Referral to Treatment (SBIRT) model based occupational mental health intervention, and implemented in a web-based format with a smartphone application.

METHODS

The SBIRT-based intervention was developed by a multidisciplinary team, including occupational health physicians, nurses, psychiatrists, and software developers. The following mental health areas were included, based on outcomes of an epidemiological survey conducted: insomnia, depression, anxiety, problematic alcohol use, and suicidal risk. The viability of the two-step evaluation process utilizing a combination of the brief version and the full-length version of the questionnaire was examined using responses from the survey. The intervention was adjusted according to the survey results and expert opinions.

RESULTS

The epidemiological survey included 346 employees who completed the long-form version of mental health scales. These data were the used to confirm the diagnostic value of using a combination of short-form and long-form version of the scales for screening in the SBIRT model. The model uses a smartphone application for screening, provision of psychoeducation, and for surveillance. The universal methods of the model ensure it can be implemented by all occupational managers, regardless of their specialization in mental health. In addition to the two-step screening procedure to identify employees at-risk for mental health problems, the model includes a stepped care approach, based on risk stratification, to promote mental health education, management, and follow-up for continuous care.

CONCLUSION

The SBIRT model-based intervention provides an easy-to-implement approach for the management of mental health in the workplace. Further studies are required to examine the effectiveness and feasibility of the model.

Occupational characteristics and incident anxiety and depression: A prospective cohort study of 206,790 participants

BACKGROUND

This study aimed to analyze the impact of a wide spectrum of occupational characteristics on the incidence of anxiety and depression, and to determine the features affecting adaptation to specific characteristics.

METHODS

Participants in paid employment or self-employed at baseline in UKB were included, with occupational characteristics extracted from O*NET. Cox-proportional-hazard models were conducted in the main analyses and subgroup analyses.

RESULTS

Direct work with the public and exposure to disease/infections were first time demonstrated to be risk factors for both anxiety and depression, along with occupations involving more physical activities and dealing with unpleasant/physically aggressive people. Protective factors for both: time spent sitting, communication, decision making, creativity and reasoning, and responsibility in work. Protective factors for anxiety only: Coordinating/leading, fluency of ideas, originality, problem sensitivity, decision latitude, and time pressure. Risk factor for depression only: Exposure to contaminants. Females were found more sensitive to dealing with unpleasant/physically aggressive people. The impact of exposure to disease/infections was more significant among those with lower education levels. Those with BMI over 24 were more sensitive to the risk factors.

LIMITATIONS

The short-term effect of the above exposures remained unclear. The scores of occupational characteristics were based on self-reported questionnaires. There was the potential for undiagnosed anxiety or depression events. The participants included only those aged from 40 to 69. Participants included in this cohort were mainly White British.

CONCLUSIONS

Our findings advocate closer monitoring of the mental health of workers with risk work-related factors.

The Geography of Mental Health, Urbanicity, and Affluence

Residential location has been shown to significantly impact mental health, with individuals in rural communities experiencing poorer mental health compared to those in urban areas. However, the influence of an individual's social group on the relationship between residential location and mental health outcomes remains unclear. This study disaggregates the rural-urban binary and investigates how geography and social groupings interact to shape mental health outcomes. Merging data from PLACES and Claritas PRIZM, we conducted a hotspot analysis, generated bivariate choropleth maps, and applied multiscale geographically weighted regressions to examine the spatial distribution of mental health and social groupings. Our findings reveal that mental health is influenced by complex interactions, with social groups playing a critical role. Our study highlights that not all rural and urban areas are alike, and the extent to which social groups influence mental health outcomes varies within and across these areas. These results underscore the need for policies that are tailored to meet the unique mental health needs of individuals from different social groups in specific geographic locations to inform policy interventions that more effectively address mental health disparities across diverse communities.

Validation of the Occupational Depression Inventory in Brazil: A study of 1612 civil servants

OBJECTIVE

The Occupational Depression Inventory (ODI) assesses work-attributed depressive symptoms. The ODI has demonstrated robust psychometric and structural properties. To date, the instrument has been validated in English, French, and Spanish. This study examined the psychometric and structural properties of the ODI's Brazilian-Portuguese version.

METHODS

The study involved 1612 civil servants employed in Brazil (M_AGE = 44, SD_AGE = 9; 60% female). The study was conducted online across all Brazilian states.

RESULTS

Exploratory structural equation modeling (ESEM) bifactor analysis indicated that the ODI meets the requirements for essential unidimensionality. The general factor accounted for 91% of the common variance extracted. We found measurement invariance to hold across sexes and age groups. Consistent with these findings, the ODI showed strong scalability (H = 0.67). The instrument's total score accurately ranked respondents on the latent dimension underlying the measure. Furthermore, the ODI exhibited excellent total-score reliability (e.g., McDonald's ω = 0.93). Occupational depression correlated negatively with work engagement and each of its components (vigor, dedication, and absorption), speaking to the ODI's criterion validity. Finally, the ODI helped clarify the issue of burnout-depression overlap. Relying on ESEM confirmatory factor analysis (CFA), we found burnout's components to correlate more strongly with occupational depression than with each other. Using a higher-order ESEM-within-CFA framework, we found a correlation of 0.95 between burnout and occupational depression.

CONCLUSION

The ODI displays robust psychometric and structural properties within the Brazilian context. The ODI constitutes a valuable resource for occupational health specialists and may help advance research on job-related distress.

Effects of Suryanamaskar, an Intensive Yoga Exercise Routine, on the Stress Levels and Emotional Intelligence of Indian Students

The inability of an individual to identify, assess, and manage emotions and levels of stress has adverse individual and societal consequences. Previous studies have shown that yoga-based interventions can successfully treat stress, anxiety, and depression, and can enhance emotional control. The aim of the current study was to assess the effect of a specific, intensive, yoga-based intervention, Dynamic Suryanamaskar, on the levels of perceived stress and emotional intelligence in Indian male school students. One hundred and five students with a median age of 17.15 ± 1.42 years were assessed. Practice took place over 12 weeks (n = 70 workouts). The Perceived Stress Scale (PSS) questionnaire and the emotional intelligence (EQ) questionnaire, developed for the Indian population, were used to measure stress and emotional levels at the start and end of the study. The Solomon four-group design was used to ensure statistical reliability. The post-study univariate analysis of covariance ANOVA between groups (p < 0.001) and the t-test for independent samples (p < 0.05) indicated that, for those using the Dynamic Suryanamaskar protocol, there was a significant reduction in stress levels and a significant (p < 0.01) increase in the levels of emotional intelligence. This study thus provides further evidence of the benefits of the practice of Dynamic Suryanamaskar.

Towards a new approach to job-related distress: A three-sample study of the Occupational Depression Inventory

The Occupational Depression Inventory (ODI) was recently developed to assess depressive symptoms that individuals specifically attribute to their work. One purpose of the ODI is to respond to limitations of current assessments of job-related distress, most notably, assessments relying on the burnout construct. In this study, we conducted a thorough examination of the psychometric and structural properties of the ODI using exploratory structural equation modelling bifactor analysis and Mokken scale analysis. The study involved three samples of employed individuals, recruited in France (N = 3454), Switzerland (N = 1971), and Australia (N = 1485). Results were consistent across the three samples. The ODI exhibited essential unidimensionality and excellent total-score reliability-as indexed by McDonald's omega, Cronbach's alpha, Guttman's lambda-2, and the Molenaar-Sijtsma statistic. We found evidence for measurement invariance across sexes, age groups, and samples. Mokken scale analysis revealed that the ODI's scalability was strong. No monotonicity violation was detected. Invariant item ordering showed sufficient accuracy. In all three samples, suicidal ideation was the least commonly endorsed item-thus acting as a sentinel item-and fatigue/loss of energy was the most commonly endorsed item. The ODI exhibits excellent psychometric and structural properties, suggesting that occupational health specialists can effectively employ the instrument.

The Relationship between Job Satisfaction and Depressive Symptoms among Chinese Adults Aged 35-60 Years: The Mediating Role of Subjective Well-Being and Life Satisfaction

The purpose of this study was to assess the serial multiple mediating effects of subjective well-being and life satisfaction between job satisfaction and depressive symptoms among Chinese adults aged 35-60 years. According to the 2018 China Family Panel Study (CFPS), we finally selected 10,609 respondents (5202 females, and 5407 males) aged 35-60 years old as samples for the study. Correlation analysis was carried out to examine the relationship among job satisfaction, subjective well-being, life satisfaction, and depressive symptoms. Linear regression models were established to analyze the relationship between job satisfaction and depressive symptoms. Serial multiple mediation analysis was conducted by the SPSS macro PROCESS program. The results suggested that job satisfaction was negatively correlated with depressive symptoms among Chinese adults aged 35-60 years. Subjective well-being and life satisfaction mediated the relationships between them, respectively. Furthermore, job satisfaction also had indirect impacts on depressive symptoms through the serial mediating effects of subjective well-being and life satisfaction. The findings revealed that increasing job satisfaction could decrease depressive symptoms through promoting subjective well-being and life satisfaction. The study may offer some meaningful implications for improving the mental health and reducing the risk of depressive symptoms among Chinese adults aged 35-60 years.

Personality disorders as a predictor of counterproductive knowledge behavior: the application of the Millon Clinical Multiaxial Inventory-IV

Purpose

This study investigates the role of personality disorders in the context of counterproductive knowledge behavior.

Design/methodology/approach

Data were collected through a survey administered to 120 full-time employees recruited from Amazon’s Mechanical Turk. Personality disorders were measured by means of the Millon Clinical Multiaxial Inventory-IV.

Findings

Personality disorders play an important role in the context of counterproductive knowledge behavior: employees suffering from various personality disorders are likely to hide knowledge from their fellow coworkers and engage in knowledge sabotage. Of particular importance are dependent, narcissistic and sadistic personality disorders as well as schizophrenic and delusional severe clinical syndromes. There is a need for a paradigm shift in terms of how the research community should portray those who engage in counterproductive knowledge behavior, reconsidering the underlying assumption that all of them act deliberately, consciously and rationally. Unexpectedly, most personality disorders do not facilitate knowledge hoarding.

Practical implications

Organizations should provide insurance coverage for the treatment of personality disorders, assist those seeking treatment, inform employees about the existence of personality disorders in the workplace and their impact on interemployee relationships, facilitate a stress-free work environment, remove social stigma that may be associated with personality disorders and, as a last resort, reassign workers suffering from extreme forms of personality disorders to tasks that require less interemployee interaction (instead of terminating them).

Originality/value

To the best of the authors’ knowledge, this work represents one of the first attempts to empirically investigate the notion of personality disorders in the context of knowledge management.

Pelvic floor dysfunction and its impact on quality of life among female health care employees

BACKGROUND

In today's fast-paced world, both men and women have to be equally competent to handle their responsibilities in order to look after their family members and children. In this pace of competency women tend to forget to take care of their own health and face many health issues, including pelvic floor dysfunction.

OBJECTIVE

This study aimed to analyse the prevalence rate of pelvic floor dysfunction among the working women in regards to their age and body mass index as well as their quality of life.

METHODS

One hundred sixty one post-partum working female participants from the medical fraternity were involved in this study after their consent was obtained. Pelvic floor muscle strength was assessed and their quality of life measured using King's health questionnaire.

RESULTS

There was a strong correlation between the pelvic floor muscle dysfunction and its impact on the quality of life among the females with increasing age. Significant statistical significant difference of P(<0.0001) was noted.

CONCLUSION

Pelvic floor dysfunction among females has a direct impact on their quality of life.

The microbiota-gut-brain axis in stress and depression

Humans and animals are evolved to have instinctive physiological responses to threats. The perception of threat by the brain triggers a multitude of changes across the brain and body. A large body of research have demonstrated that our hardwired survival instinct, the stress response, can become maladaptive and promote major depressive disorders and other neuropsychiatric impairments. However, gaps in our understanding of how chronic stress contributes to depression and mental disorders suggest that we also need to consider factors beyond the biology of the host. The unravelling of the structure and function of microorganisms that humans and animals are host to have driven a paradigm shift in understanding the individual as a collective network composed of the host plus microbes. Well over 90% of bacteria in the body reside in the large intestines, and these microbes in the lower gut function almost like an organ in the body in the way it interacts with the host. Importantly, bidirectional interactions between the gut microbiota and the brain (i.e., the two-way microbiota-gut-brain axis) have been implicated in the pathophysiology of mental disorders including depression. Here, in summarizing the emerging literature, we envisage that further research particularly on the efferent brain-gut-microbiota axis will uncover transformative links in the biology of stress and depression.

Communication Apprehension and Willingness to Communicate in Veterinary Medicine Students: Implications for Mindfulness and Communication Training

Across two studies we investigated the relationship among mindfulness, rumination, depression, stress, anxiety, communication apprehension, and willingness to communicate among veterinary medicine students. Study 1 tested a hypothesized path model of the relationship with 148 third-year students. Study 2 confirmed the path model with second sample of 160 third-year students. Mindfulness had a direct negative relationship with communication apprehension and a direct positive relationship with willingness to communicate, whereas depression, anxiety, and stress each had a direct negative relationship with communication apprehension and willingness to communicate. Rumination was also directly associated with communication apprehension and willingness to communicate, and it was mediated through depression, anxiety, and stress. These findings suggest mindfulness training may mitigate depression, anxiety, and stress and their attendant effects on communication apprehension and willingness to communicate.

Shifts in Stressors, Internalizing Symptoms, and Coping Mechanisms of Teachers During the COVID-19 Pandemic

As the frontline of our education system, teachers endure greater job-related stress than other professionals, even under the best of circumstances. While they were already exposed to certain stressors affecting their emotional health, the pandemic outbreak introduced new challenges putting teachers at risk of experiencing higher rates of emotional distress. This longitudinal study aimed to identify changes in teaching stressors and teachers' coping strategies in the period before the pandemic to the immediate outbreaks of COVID-19 in Fall 2020. In addition, we examined the correlation of teachers' coping approaches with stress, anxiety, and depression to understand if coping strategies correlate and predict such emotional distress. To this end, 376 English as a foreign language (EFL) teachers in Iran in the first wave and 351 in the second wave completed a battery of validated inventories capturing their emotional distress, teaching stressors, and coping approaches. The mean scores of the stressors and coping strategies across two waves indicated significant shifts toward using functional coping strategies upon experiencing new demands. Furthermore, we found that novice teachers experienced higher rates of stress and anxiety, which were positively associated with dysfunctional coping strategies. The results of the stepwise regression analysis with (dys)functional coping strategies indicated that coping mechanisms significantly account for 25% of variances in stress, anxiety, and depression. The implications of the study regarding promoting teacher mental health through identifying the risk factors associated with dysfunctional coping strategies have been discussed.

The association of perceived leadership style and subjective well-being of employees in a tertiary hospital in Germany

BACKGROUND

Professionals in the healthcare sector are a particularly vulnerable group for occupational strain due to high work-related psychological stress. For the implementation of targeted stress-prevention interventions as an important part of a workplace health management programme for all occupational groups and hierarchy levels, information about the current state of their mental health is mandatory. Hence, this study investigated the association of general well-being and different leadership styles among employees in a German tertiary hospital.

METHODS

Via an online survey, 10,101 employees were contacted. The final sample consisted of 1137 employees. Of these, 27.7% described themselves as leaders and 72.3% as followers. Most participants were female (74.8%), more than half were under 41 years old. Besides control variables, general well-being (WHO-5) and leadership style (transactional and transformational, laissez-faire and destructive leadership) were assessed.

RESULTS

Leaders reported higher well-being scores than followers. Physicians without leadership responsibilities had the lowest scores for well-being. Practitioners of both transformational and transactional leadership were associated with higher well-being scores, while those practicing laissez-faire and destructive leadership had lower scores for almost every professional group.

CONCLUSION

Results highlight the necessity for future multimodal health-preventive leadership interventions feature behavioural and organizational intervention modules specifically tailored to hospital professionals at different hierarchical and functional levels to foster the mental health of employees.

Perceived stress modulates the activity between the amygdala and the cortex

The significant link between stress and psychiatric disorders has prompted research on stress's impact on the brain. Interestingly, previous studies on healthy subjects have demonstrated an association between perceived stress and amygdala volume, although the mechanisms by which perceived stress can affect brain function remain unknown. To better understand what this association entails at a functional level, herein, we explore the association of perceived stress, measured by the PSS10 questionnaire, with disseminated functional connectivity between brain areas. Using resting-state fMRI from 252 healthy subjects spanning a broad age range, we performed both a seed-based amygdala connectivity analysis (static connectivity, with spatial resolution but no temporal definition) and a whole-brain data-driven approach to detect altered patterns of phase interactions between brain areas (dynamic connectivity with spatiotemporal information). Results show that increased perceived stress is directly associated with increased amygdala connectivity with frontal cortical regions, which is driven by a reduced occurrence of an activity pattern where the signals in the amygdala and the hippocampus evolve in opposite directions with respect to the rest of the brain. Overall, these results not only reinforce the pathological effect of in-phase synchronicity between subcortical and cortical brain areas but also demonstrate the protective effect of counterbalanced (i.e., phase-shifted) activity between brain subsystems, which are otherwise missed with correlation-based functional connectivity analysis.

Age-period-cohort analysis of depression trends: are depressive symptoms increasing across generations in Germany?

Several studies have examined trends in depression, but only few have explicitly considered possible generational differences. I examined changes in the burden of depressive symptoms between 2002 and 2017 according to age, time period and birth cohort in Germany. I used population-based data drawn from the German Aging Survey (N = 33,723, 54% female, ages 40 +) from 2002, 2008, 2011, 2014, and 2017. Depressive symptoms were measured via the CES-D 15. Hierarchical age-period-cohort models were used to examine trends in depression. I found that depressive symptoms changed across age, time period and birth cohorts. While there was a general decrease across time periods, strong evidence for a U-shaped cohort effect was also found: Younger generations, beginning with cohorts born after the World War II, increasingly report more depressive symptoms than older generations. This U-shaped cohort trend appeared most pronounced for the somatic symptoms subscale. Contrarily, only minimal cohort differences were found regarding the positive affect subscale. Therefore, depressive symptoms, and especially somatic symptoms, seem to increase in more recent birth cohorts in Germany, who might thus be at risk to experience more mental health problems in the future. Potential reasons for these trends and the generalizability of the results to other countries should be investigated by future studies.

Relationship between Job Burnout, Depressive Symptoms, and Career Choice Regret among Chinese Postgraduates of Stomatology

A qualified Chinese dental postgraduate requires at least eight years of training. The huge academic burden, strict clinical requirements, and high workload increases the risk of job burnout, depression symptoms, and career choice regret of dental postgraduates, which may cause one to waver in their choice of a career as a doctor. Therefore, we aimed at assessing the relationship between job burnout, depressive symptoms, and career choice regret among Chinese dental postgraduates. The Chongqing Stomatological Association conducted an online cross-sectional study among 558 dental postgraduates in China, with an average age of 22.54 ± 2.44. Demographic information, the Maslach Burnout Inventory, the 2-item Primary Care Evaluation of Mental Disorders scale, and career choice regret scale were included in the questionnaire. About 41.0% of dental postgraduates experienced job burnout, 44.1% had depressive symptoms, and 41.6% reported career choice regret. Logistic regression analysis indicated the risk factors for job burnout were time worked/studied per week, depressive symptoms, and career choice regret. Job burnout and career choice regret was significantly related to depressive symptoms (p < 0.001). Risk factors for career choice regret were gender, postgraduate entrance examination score, daily hours of sleep, job burnout, and depressive symptoms. Such results suggest that job burnout, depressive symptoms, and career choice regrets are prevalent among dental postgraduates. Accurate measures should be taken to change this situation.

Work schedule flexibility and teleworking were not good together during COVID-19 when testing their effects on work overload and mental health

The COVID-19 pandemic has driven organizations to implement various flexible work arrangements. Due to a lack of longitudinal studies, there is currently no consensus in specialized literature regarding the consequences of flexible work arrangements on employee mental health, as well any long term potential impacts. Using the Job Demand-Resource Model, this study documents consequences of the implementation of two types of flexible work arrangement: work schedule flexibility and teleworking on employee mental health over time, and the mediating role played by work overload during the accelerated implementation of flexible work arrangements in the course of the COVID-19 pandemic. Using a longitudinal design and probabilistic sampling, 209 workers participated in this study, twice answering a flexible work arrangement and mental health questionnaire during the pandemic. Findings of this moderated-mediation suggest that work schedule flexibility generates positive effects on mental health over time due to decreased work overload, but only for employees not working from home. These results offer theoretical and practical implications applicable to organizations considering implementation of flexible work arrangements, particularly with regard to how these flexible practices could support a balance between demand and resources, their impact on work overload, and employee mental health over time.

Association of residential noise exposure with maternal anxiety and depression in late pregnancy

BACKGROUND

Noise is one of the most important environmental risk factors that adversely affects human health. Residential noise exposure has been associated with increased risk of anxiety and depression in the general population. However, limited study has been conducted in pregnant women.

OBJECTIVE

To examine the associations of residential noise exposure with prenatal anxiety and depression.

METHODS

Self-Rating Anxiety Scale (SAS) and Center for Epidemiological Survey Scale (CES-D) were used to assess the status of prenatal anxiety and depression for 2,018 pregnant women in Shanghai, China. Residential noise exposure was represented by a land use regression model. Multivariate logistic regression model was used to estimate the associations of noise exposure with prenatal anxiety and depression.

RESULTS

The prevalence rates of prenatal anxiety and depression were 7.5 % and 8.1 %, respectively. The mean (±standard deviation) residential noise exposure during the whole pregnancy was 60.69 (±3.31) dB (A). Higher residential noise exposure was associated with increased odds of both prenatal anxiety and depression. Compared with low level of noise exposure group (<65 dB(A)), the odds of prenatal anxiety and depression increased 69 % (OR = 1.69, 95 % CI, 1.01-2.82) and 71 % (OR = 1.71, 95 % CI, 1.05-2.80) in higher noise exposure group (≥65 dB(A)), respectively. Stratified analyses showed that the associations were stronger among pregnant women with lower socioeconomic status.

CONCLUSION

Residential noise exposure during pregnancy might be a risk factor for prenatal anxiety and depression.

Association of amygdala size with stress perception: Findings of a transversal study across the lifespan

Daily routines are getting increasingly stressful. Interestingly, associations between stress perception and amygdala volume, a brain region implicated in emotional behaviour, have been observed in both younger and older adults. Life stress, on the other hand, has become pervasive and is no longer restricted to a specific age group or life stage. As a result, it is vital to consider stress as a continuum across the lifespan. In this study, we investigated the relationship between perceived stress and amygdala size in 272 healthy participants with a broad age range. Participants were submitted to a structural magnetic resonance imaging (MRI) to extract amygdala volume, and the Perceived Stress Scale (PSS) scores were used as the independent variable in volumetric regressions. We found that perceived stress is positively associated with the right amygdala volume throughout life.

Impact of ambient air pollution on outdoor employees’ performance: Mediating role of anxiety

This paper aims to examine the direct and indirect impact of ambient air pollution (AAP) on employees’ performance. This study has used cross sectional survey design to collect the data from the outdoor employees of the pharmaceutical industry of Pakistan. The data were collected in time lags from 299. Partial least squares- structural equation modeling (PLS-SEM) approach was applied to analyze the data. The results show that AAP has a significant negative impact on the employees’ performance, and anxiety partially mediates the association between AAP and employees’ performance. This study reveals that AAP brings anxiety among outdoor employees, which in turn decreases their working performance. The implications, limitations, and future research directions are presented in the last section of this study.

Does Back Pain Go on Holiday in the Summer?

Back pain is one of the leading causes of disability among adults worldwide [...].

Effects of vigor at work and weekly physical activity on job stress and mental health

This study explores the role of personal resources, specifically vigor at work (a positive affect generated by the ongoing interactions in the workplace) and weekly physical activity (PA), in the stress-mental health relationship, given the positive relationships found between PA and levels of vigor experienced on health. Thus, we hypothesized that vigor at work would mediate the relationship between job stress and workers' mental health, whereas weekly PA would moderate the relationship between stress and vigor at work. Five hundred and twenty-seven workers completed self-report scales for stress, weekly PA, vigor at work, and mental health. The results showed that vigor at work was related to better mental health, whereas stress was related to high psychological problems and low vigor at work. The interaction between stress and weekly PA on vigor was significant, indicating a counterproductive effect of weekly PA. Specifically, the negative relationship between stress and vigor at work was greater when doing weekly PA. In this vein, high levels of weekly PA would not have a favorable impact when workers experience high levels of stress, consuming part of vigor at work and reducing the positive effect of vigor at work on mental health by coping with stress.

Health Care Workers' Need for Headspace: Findings From a Multisite Definitive Randomized Controlled Trial of an Unguided Digital Mindfulness-Based Self-help App to Reduce Healthcare Worker Stress

BACKGROUND

Health care workers experience high stress. Accessible, affordable, and effective approaches to reducing stress are lacking. In-person mindfulness-based interventions can reduce health care worker stress but are not widely available or accessible to busy health care workers. Unguided, digital, mindfulness-based self-help (MBSH) interventions show promise and can be flexibly engaged with. However, their effectiveness in reducing health care worker stress has not yet been explored in a definitive trial.

OBJECTIVE

This study aimed to investigate the effectiveness of an unguided digital MBSH app (Headspace) in reducing health care worker stress.

METHODS

This was a definitive superiority randomized controlled trial with 2182 National Health Service staff in England recruited on the web and allocated in a 1:1 ratio to fully automated Headspace (n=1095, 50.18%) or active control (Moodzone; n=1087, 49.82%) for 4.5 months. Outcomes were subscales of the Depression, Anxiety, and Stress (primary outcome) Scale short form; Short Warwick Edinburgh Mental Well-being Scale; Maslach Burnout Inventory; 15-item Five-Facet Mindfulness Questionnaire minus Observe items; Self-Compassion Scale-Short Form; Compassionate Love Scale; Penn State Worry Questionnaire; Brooding subscale of the Ruminative Response Scale; and sickness absence.

RESULTS

Intention-to-treat analyses found that Headspace led to greater reductions in stress over time than Moodzone (b=-0.31, 95% CI -0.47 to -0.14; P<.001), with small effects. Small effects of Headspace versus Moodzone were found for depression (b=-0.24, 95% CI -0.40 to -0.08; P=.003), anxiety (b=-0.19, 95% CI -0.32 to -0.06; P=.004), well-being (b=0.14, 95% CI 0.05-0.23; P=.002), mindfulness (b=0.22, 95% CI 0.09-0.34; P=.001), self-compassion (b=0.48, 95% CI 0.33-0.64; P<.001), compassion for others (b=0.02, 95% CI 0.00-0.04; P=.04), and worry (b=-0.30, 95% CI -0.51 to -0.09; P=.005) but not for burnout (b=-0.19, -0.04, and 0.13, all 95% CIs >0; P=.65, .67, and .35), ruminative brooding (b=-0.06, 95% CI -0.12 to 0.00; P=.06), or sickness absence (γ=0.09, 95% CI -0.18 to 0.34). Per-protocol effects of Headspace (454/1095, 41.46%) versus Moodzone (283/1087, 26.03%) over time were found for stress, self-compassion, and compassion for others but not for the other outcomes. Engagement (practice days per week) and improvements in self-compassion during the initial 1.5-month intervention period mediated pre- to postintervention improvements in stress. Improvements in mindfulness, rumination, and worry did not mediate pre- to postintervention improvements in stress. No serious adverse events were reported.

CONCLUSIONS

An unguided digital MBSH intervention (Headspace) can reduce health care workers' stress. Effect sizes were small but could have population-level benefits. Unguided digital MBSH interventions can be part of the solution to reducing health care worker stress alongside potentially costlier but potentially more effective in-person mindfulness-based interventions, nonmindfulness courses, and organizational-level interventions.

TRIAL REGISTRATION

International Standard Randomised Controlled Trial Number ISRCTN15424185; https://tinyurl.com/rv9en5kc.

Mental Health Mobile Apps in the French App Store: Assessment of Functionality and Quality (Preprint)

Background

Approximately 800 million people, representing 11% of the world’s population, are affected by mental health problems. The COVID-19 pandemic exacerbated problems and triggered a decline in well-being, with drastic increase in the incidence of conditions such as anxiety, depression, and stress. Approximately 20,000 mental health apps are listed in mobile app stores. However, no significant evaluation of mental health apps in French, spoken by approximately 300 million people, has been identified in the literature yet.

Objective

This study aims to review the mental health mobile apps currently available on the French Apple App Store and Google Play Store and to evaluate their quality using Mobile App Rating Scale–French (MARS-F).

Methods

Screening of mental health apps was conducted from June 10, 2022, to June 17, 2022, on the French Apple App Store and Google Play Store. A shortlist of 12 apps was identified using the criteria of selection and assessed using MARS-F by 9 mental health professionals. Intraclass correlation was used to evaluate interrater agreement. Mean (SD) scores and their distributions for each section and item were calculated.

Results

The highest scores for MARS-F quality were obtained by Soutien psy avec Mon Sherpa (mean 3.85, SD 0.48), Evoluno (mean 3.54, SD 0.72), and Teale (mean 3.53, SD 0.87). Mean engagement scores (section A) ranged from 2.33 (SD 0.69) for Reflexe reussite to 3.80 (SD 0.61) for Soutien psy avec Mon Sherpa. Mean aesthetics scores (section C) ranged from 2.52 (SD 0.62) for Mental Booster to 3.89 (SD 0.69) for Soutien psy avec Mon Sherpa. Mean information scores (section D) ranged from 2.00 (SD 0.75) for Mental Booster to 3.46 (SD 0.77) for Soutien psy avec Mon Sherpa. Mean Mobile App Rating Scale subjective quality (section E) score varied from 1.22 (SD 0.26) for VOS – journal de l’humeur to 2.69 (SD 0.84) for Soutien psy avec Mon Sherpa. Mean app specificity (section F) score varied from 1.56 (SD 0.97) for Mental Booster to 3.31 (SD 1.22) for Evoluno. For all the mental health apps studied, except Soutien psy avec Mon Sherpa (11/12, 92%), the subjective quality score was always lower than the app specificity score, which was always lower than the MARS-F quality score, and that was lower than the rating score from the iPhone Operating System or Android app stores.

Conclusions

Mental health professionals assessed that, despite the lack of scientific evidence, the mental health mobile apps available on the French Apple App Store and Google Play Store were of good quality. However, they are reluctant to use them in their professional practice. Additional investigations are needed to assess their compliance with recommendations and their long-term impact on users.

A Consequential Partnership

Abstract. Many studies have focused on the effects of teachers’ well-being on the development of students, in particular their academic achievement. To date, little is known about the association between teachers’ well-being and students’ well-being. In the present study, we analyzed this relationship and examined the mediating role of teacher support using linked data from 2,686 students and 805 teachers from 48 schools in Germany. Multilevel regression analyses showed a relationship between teachers’ emotional exhaustion and students’ subjective health complaints and between teachers’ psychological well-being and students’ satisfaction with school. The latter association was mediated by teacher support as perceived by students. This study extends current knowledge about the relevance of teachers’ well-being to their students’ socio-emotional development and the mechanisms that underlie this association. Implications for promoting of mental health in schools and for future research are discussed.

Work environment and labour market participation in early adulthood

BACKGROUND

Investigating whether a poor physical or psychosocial work environment is associated with low labour market participation in early adulthood is important to avoid negative health-related consequences and to improve job prospects.

AIMS

To investigate associations between the physical or psychosocial work environment and labour market participation in early adulthood.

METHODS

The study was based on data from the West Jutland Cohort, an ongoing study of individuals born in 1989 who lived in the western part of Jutland, Denmark, in 2004. Participants were employed individuals who had questionnaire data on their work environment at age 28 and register information on labour market participation at ages 28-29 (n = 1312). The outcome was categorized into low (>4 weeks) versus high (≤4 weeks) labour market participation based on the total number of weeks receiving any unemployment or health-related benefits during a 52-week period. Logistic regression analyses were performed to examine associations between work environment factors and labour market participation, taking confounders into account.

RESULTS

Low influence, low quality of leadership, high job insecurity and temporary employment were associated with low labour market participation. High job insecurity (OR: 2.2; 95% CI 1.5-3.1) and temporary employment (OR: 3.1; 95% CI 2.1-4.5) were strongly associated with low labour market participation. An association was seen between hard physical work and low labour market participation.

CONCLUSIONS

Several physical and psychosocial work environment factors, especially high job insecurity and temporary employment, have a negative impact on labour market participation in early adulthood.

Are Australian teachers burned-out or depressed? A confirmatory factor analytic study involving the Occupational Depression Inventory

OBJECTIVE

There is mounting evidence that burnout problematically overlaps with depression. However, the generalizability of this finding remains debated. This study examined the burnout-depression distinction based on a recently developed measure of work-attributed depressive symptoms-the Occupational Depression Inventory (ODI).

METHODS

We relied on a sample of 891 Australian teachers. The ODI was employed to assess work-attributed depressive symptoms. The Shirom-Melamed Burnout Measure (SMBM) and the Oldenburg Burnout Inventory (OLBI) were employed to assess burnout symptoms. The SMBM assesses burnout as a syndrome combining physical fatigue, cognitive weariness, and emotional exhaustion. The OLBI assesses burnout as a syndrome of exhaustion and disengagement.

RESULTS

Confirmatory factor analysis indicated that the factors underlying burnout's components correlated more highly with the Occupational Depression factor than with each other, calling into question the syndromal unity of burnout. Moreover, the factors underlying burnout's components and the Occupational Depression factor were reflective of a common higher-order factor.

CONCLUSIONS

Our findings are consistent with the view that burnout symptoms are part of a depressive syndrome and do not reflect a unique or distinct entity. Conducted in the Australian context, this study strengthens the generalizability of the finding that burnout problematically overlaps with depression. Given the profound problems affecting the burnout construct, we recommend a paradigm shift from burnout to occupational depression. Such a shift raises the prospects of more reliably and validly assessing severity and prevalence of job-related distress and, consequently, of reaching more psychologically meaningful and productive conclusions regarding treatment, prevention, and public health decision-making.